Pressurized Intra-peritoneal Aerosol Chemotherapy (PIPAC) via Endoscopical Microcatheter System

Anticancer Res. 2018 Jun;38(6):3447-3452. doi: 10.21873/anticanres.12613.

Abstract

Background/aim: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is becoming an increasingly widespread approach for delivering intra-peritoneal chemotherapy (IPC) by means of a chemoaerosol. Currently, the aerosol dispersion is achieved by using a special micropump (MIP®). However, the delivery of a chemoaerosol into the abdominal cavity is not limited to the MIP®. This study aimed to investigate the feasibility, drug penetration and distribution of PIPAC via an established endoscopical microcatheter (MC).

Materials and methods: An established ex vivo PIPAC model containing native fresh tissue samples of swine peritoneum was used to aerosolize doxorubicin at a pressure of 12 mm Hg CO2 at 27° degrees Celsius. On the top cover of the PIPAC chamber a MC device was installed via trocar. Tissue specimens were placed as follows: at the bottom of the plastic box (A), at the side wall (B), at the top (C) and the covered bottom (D) of the box. In-tissue doxorubicin penetration was measured using fluorescence microscopy on frozen thin sections.

Results: The mean depth of doxorubicin penetration was found to be significantly higher in tissue directly exposed to the aerosol jet. All samples had contact with doxorubicin. Penetration rates were: A: 348 (+/- 47 μm), B: 174 (+/- 64 μm), C: 92 (+/- 27 μm) and D: 84 (+/- 45) μm.

Conclusion: Our ex vivo data suggest that PIPAC can be delivered via MC device. While local drug penetration is practically congruent to known PIPAC performance with MIP®, the MC offers a feasible, flexible, easy to handle and economic improvement compared to conventional PIPAC.

Keywords: PIPAC; Pressurized intra-peritoneal aerosol chemotherapy; doxorubicin; ex vivo; swine.

MeSH terms

  • Aerosols / administration & dosage*
  • Aerosols / pharmacokinetics
  • Animals
  • Antibiotics, Antineoplastic / administration & dosage
  • Antibiotics, Antineoplastic / pharmacokinetics
  • Catheters
  • Doxorubicin / administration & dosage*
  • Doxorubicin / pharmacokinetics
  • Drug Delivery Systems / methods*
  • Endoscopy
  • Microscopy, Fluorescence
  • Peritoneum / drug effects*
  • Peritoneum / metabolism
  • Pressure
  • Swine
  • Tissue Distribution

Substances

  • Aerosols
  • Antibiotics, Antineoplastic
  • Doxorubicin