Consensus Statement for Treatment Protocols in Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC)

Overview

Journal Pleura Peritoneum

Date 2022 May 23

PMID 35602919

Authors

Olivia Sgarbura

Clarisse Eveno

Mohammad Alyami

Naoual Bakrin

Delia Cortes Guiral

Wim Ceelen

Xavier Delgadillo

Thanh Dellinger

Andrea Di Giorgio

Amaniel Kefleyesus

Vladimir Khomiakov

Michael Bau Mortensen

Jamie Murphy

Marc Pocard

Marc Reymond

Manuela Robella

Koen P Rovers

Jimmy So

S P Somashekhar

Clemens Tempfer

Kurt van Der Speeten

Laurent Villeneuve

Wei Peng Yong

Martin Hubner

Affiliations

Soon will be listed here.

Abstract

Objectives: Safe implementation and thorough evaluation of new treatments require prospective data monitoring and standardization of treatments. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a promising alternative for the treatment of patients with peritoneal disease with an increasing number of suggested drug regimens. The aim was to reach expert consensus on current PIPAC treatment protocols and to define the most important research topics.

Methods: The expert panel included the most active PIPAC centers, organizers of PIPAC courses and principal investigators of prospective studies on PIPAC. A comprehensive literature review served as base for a two-day hybrid consensus meeting which was accompanied by a modified three-round Delphi process. Consensus bar was set at 70% for combined (strong and weak) positive or negative votes according to GRADE. Research questions were prioritized from 0 to 10 (highest importance).

Results: Twenty-two out of 26 invited experts completed the entire consensus process. Consensus was reached for 10/10 final questions. The combination of doxorubicin (2.1 mg/m) and cisplatin (10.5 mg/m) was endorsed by 20/22 experts (90.9%). 16/22 (72.7%) supported oxaliplatin at 120 with potential reduction to 90 mg/m (frail patients), and 77.2% suggested PIPAC-Ox in combination with 5-FU. Mitomycin-C and Nab-paclitaxel were favoured as alternative regimens. The most important research questions concerned PIPAC conditions (n=3), standard (n=4) and alternative regimens (n=5) and efficacy of PIPAC treatment (n=2); 8/14 were given a priority of ≥8/10.

Conclusions: The current consensus should help to limit heterogeneity of treatment protocols but underlines the utmost importance of further research.

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