Journal Article Ahead of print
PubMed: 41830675 DOI: 10.1016/j.ejso.2026.111731
Feasibility and safety profile of high-dose oxaliplatin-based PIPAC (120mg/m2) in the treatment of advanced peritoneal metastatic disease: MINOS real-life multicenter study.
Eur J Surg Oncol 52(5):111731
Authors: Diego A Zambrano, Alexandru Lintis, Amaniel Kefleyesus, Abdelkader Taibi, Clarisse Eveno, Marc Pocard, Guillaume De Meeus, François Quénet, Vahan Kepenekian, Martin Hübner, Olivier Glehen, Olivia Sgarbura
Affiliations
- Department of Surgical Oncology, Institut du Cancer Montpellier, University of Montpellier, Montpellier, France; Sociedad de Lucha Contra el Cáncer SOLCA-Guayaquil, Ecuador; Universidad Espíritu Santo-Ecuador, UEES, Samborondón, Ecuador.
- University Hospital CHU Lyon Sud, Pierre-Benite, France.
- University Hospital CHUV Lausanne, Lausanne, Switzerland.
- CHU Limoges, Limoges, France.
- CHU Lille, Lille, France.
- CHU Pitié-Salpêtrière, Paris, France.
- Department of Surgical Oncology, Institut du Cancer Montpellier, University of Montpellier, Montpellier, France.
- Department of Surgical Oncology, Institut du Cancer Montpellier, University of Montpellier, Montpellier, France; IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut régional du Cancer de Montpellier, Montpellier, F-34298, France.
Abstract
INTRODUCTION
Oxaliplatin (Ox) is one of the recommended agents in Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) that benefitted of several phase I trials. Based on these data, the dose of 120 mg/m 2 was suggested by an expert consensus for fit patients with peritoneal metastases (PM) of gastrointestinal cancers. The aim of the current study is to determine the real-life feasibility and safety profile of this regimen.
MATERIAL AND METHODS
This retrospective study included all patients treated with PIPAC-Ox 120 mg/m 2 in six referral centers specialized in PM. The patients were assessed for all potential toxicities associated to high dose oxaliplatin. Adverse events were expressed with the use of CTCAE for medical complications and Clavien-Dindo for surgical complications. Logistic regression and multivariate analysis were performed.
RESULTS
259 PIPAC procedures were performed in 91 patients (53 male) diagnosed with unresectable PM of various origins; most patients (n = 62) having colorectal PM. Concomitant IV 5FU was performed in 70 patients. All patients underwent the first PIPAC-Ox 120 mg/m 2, and 44 patients (48.3%) had ≥3 PIPAC. Abdominal pain was the most frequent grade III toxicity at the first PIPAC-Ox (n = 34) while 30 patients routinely received continuous IV opioids. Nausea-vomiting and ascites infection were the others grade III toxicity observed at PIPAC 1, one in each case respectively. After PIPAC 3, RECIST partial/stable response in 68.2%; PRGS 1-2 in 77.3% and negative cytology in 50% of patients.
CONCLUSIONS
High-dose PIPAC-Ox is feasible and safe. Local and histological response are well identified. However abdominal pain remains a main concern and continuous IV protocols should be considered routinely.
MeSH
Safety, Pain, Oxaliplatin, Therapeutics, Medical Oncology, Pressurized Intraperitoneal Aerosol Chemotherapy