Normal view MARC view ISBD view

Pharmacokinetics of the intraperitoneal nanoparticle pegylated liposomal doxorubicin in patients with peritoneal metastases. [Review]

MedStar author(s):

Citation: European Journal of Surgical Oncology. 2019 Mar 29PMID: 30954354Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2019 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:2002-2007ISSN:

0748-7983

Name of journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical OncologyAbstract: BACKGROUND: Peritoneal surfaces are a common site for the dissemination of gastrointestinal and gynecologic malignancy. Often, the surgeon can achieve a complete response. Unfortunately, current perioperative chemotherapy regimens fail to maintain control of cancer nodules within the abdomen and pelvis. More effective perioperative chemotherapy is needed.CONCLUSIONS: The nanoparticle PLD is slowly absorbed into the intraperitoneal tissues and not appropriate for HIPEC. EPIC is the preferred methodology for administration.Copyright (c) 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.MATERIALS AND METHODS: The nanoparticle pegylated liposomal doxorubicin (PLD) was instilled directly into the peritoneal space in peritoneal metastases patients following maximal efforts of cytoreductive surgery to resect abdominal and pelvic disease. Pharmacokinetics were determined intraoperatively during hyperthermic intraperitoneal chemotherapy (HIPEC) conditions and postoperatively during early postoperative intraperitoneal chemotherapy (EPIC) at normothermic conditions.RESULTS: The retention of PLD within the peritoneal tissues over a 90-min HIPEC was only approximately 20% and 180min of HIPEC 40%. The median area under the curve ratio of peritoneal fluid concentration times time as compared to plasma concentration times was over 1000 and increased with dose escalation from 50 to 100 mg/m2. When PLD was instilled for EPIC, the area under the curve ratios were very similar to the HIPEC but retention of drug within the peritoneal tissues with access to cancer nodules was maintained for 24h with approximately 80% drug utilization. Adverse events were tabulated and found to be absent. No evidence of peritoneal dysfunction from sclerosis was evident with a 1 year of follow-up.All authors: Stuart OA, Sugarbaker PHFiscal year: FY2019Digital Object Identifier:

https://dx.doi.org/10.1016/j.ejso.2019.03.035

Date added to catalog: 2019-05-21

Holdings ( 1 )
Title notes ( 7 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	30954354	Available		30954354

Available online from MWHC library: 1995 - present, Available in print through MWHC library:2002-2007

BACKGROUND: Peritoneal surfaces are a common site for the dissemination of gastrointestinal and gynecologic malignancy. Often, the surgeon can achieve a complete response. Unfortunately, current perioperative chemotherapy regimens fail to maintain control of cancer nodules within the abdomen and pelvis. More effective perioperative chemotherapy is needed.

CONCLUSIONS: The nanoparticle PLD is slowly absorbed into the intraperitoneal tissues and not appropriate for HIPEC. EPIC is the preferred methodology for administration.

MATERIALS AND METHODS: The nanoparticle pegylated liposomal doxorubicin (PLD) was instilled directly into the peritoneal space in peritoneal metastases patients following maximal efforts of cytoreductive surgery to resect abdominal and pelvic disease. Pharmacokinetics were determined intraoperatively during hyperthermic intraperitoneal chemotherapy (HIPEC) conditions and postoperatively during early postoperative intraperitoneal chemotherapy (EPIC) at normothermic conditions.

RESULTS: The retention of PLD within the peritoneal tissues over a 90-min HIPEC was only approximately 20% and 180min of HIPEC 40%. The median area under the curve ratio of peritoneal fluid concentration times time as compared to plasma concentration times was over 1000 and increased with dose escalation from 50 to 100 mg/m2. When PLD was instilled for EPIC, the area under the curve ratios were very similar to the HIPEC but retention of drug within the peritoneal tissues with access to cancer nodules was maintained for 24h with approximately 80% drug utilization. Adverse events were tabulated and found to be absent. No evidence of peritoneal dysfunction from sclerosis was evident with a 1 year of follow-up.

English