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817 Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for unresectable peritoneal metastases in ovarian cancer: insights from an Indian tertiary care cancer center’s initial experience
  1. Pranjal Banthia
  1. AIIMS, New-Delhi, Delhi, India


Introduction/Background Advanced ovarian cancer’s resistance to systemic chemotherapy impedes full cytoreduction. Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) provides a novel intraperitoneal palliative solution for unresectable metastases. PIPAC’s benefits—uniform distribution, low toxicity, and enhanced tumor penetration—fuel its global adoption. Our inaugural study investigates taxane-PIPAC, evaluating safety, feasibility, and response rates. We focus on PIPAC as a treatment for peritoneal surface metastases in recurrent or progressive ovarian cancer, conducting survival analyses to identify prognostic factors.

Methodology At Dr BRA-IRCH, a Tertiary Care Cancer Centre affiliated with AIIMS, New Delhi, this retrospective cohort study analyzed the clinical practices of ovarian cancer patients with peritoneal surface metastases (PSM) undergoing Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC). Initial palliative treatment outside clinical trials was common. The study evaluated feasibility, safety, morbidity, and objective oncological response endpoints. Multivariate analysis identified prognostic factors for Overall Survival (OS) and Progression-Free Survival (PFS).

Results Between 2021 and 2023, our study of 11 patients (excluding early recurrence) revealed comparable baseline characteristics, differing chemotherapy frequency, and peritoneal carcinomatosis index (PCI) before Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC). After three PIPAC cycles, both platinum-sensitive (PS) and resistant (PR) groups exhibited significantly decreased median PCI (PS 18 vs. 10, p < 0.001; PR 24 vs. 20, p = 0.009). Overall morbidity was 11%, with minimal severe complications (0–3%) and one mortality. PS group showed higher pathological response and longer Overall Survival (OS) (20 vs. 11 months, p = 0.012) and Progression-Free Survival (PFS) (18 vs. 7 months, p = 0.033). Multivariate analysis identified ascites, positive cytology at first PIPAC, and ≥ 3 PIPACs as independent prognostic factors for OS and PFS.

Conclusion PIPAC offers safe palliative care for advanced ovarian cancer with low morbidity and mortality. After 3 cycles, promising outcomes reduce peritoneal burden, highlighting potential for further research on PIPAC as an independent prognostic factor.

Disclosures None.

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