A Clinical Pharmacological Perspective on Intraperitoneal Chemotherapy.

IF 13 1区 医学 Q1 PHARMACOLOGY & PHARMACY
Drugs Pub Date : 2025-05-24 DOI:10.1007/s40265-025-02195-9
Pascale C S Rietveld, Niels A D Guchelaar, Sebastiaan D T Sassen, Birgit C P Koch, Ron H J Mathijssen, Stijn L W Koolen
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引用次数: 0

Abstract

Peritoneal metastases (PM), frequently observed in malignancies such as ovarian, colorectal, pancreatic, and gastric cancers, present a significant therapeutic challenge due to poor prognosis and limited effectiveness to systemic chemotherapy. The peritoneal-plasma barrier reduces effective drug transfer from plasma to the peritoneal cavity, reducing cytotoxic effects on PM. Intraperitoneal (IP) chemotherapy offers a locoregional approach, enabling high local drug concentrations that can enhance therapeutic efficacy while limiting systemic toxicity. The three major methods for IP administration-hyperthermic intraperitoneal chemotherapy (HIPEC), pressurized intraperitoneal aerosol chemotherapy (PIPAC), and catheter-based IP (CBIP) chemotherapy-each provide unique pharmacokinetic (PK) advantages for PM treatment. This review provides a comprehensive update on the pharmacological rationale of IP chemotherapy, focusing on drug characteristics that support extended IP retention and effective tumor targeting. The effects of administration variables are discussed, highlighting their role in optimizing IP drug exposure. Additionally, recent PK data on commonly used drugs in IP therapy, including platinum-based agents, taxanes, and novel nanoparticle formulations, will be evaluated. While PK rationale supports the administration of IP chemotherapy, further efficacy results from ongoing clinical trials are still awaited. Innovations in nanoparticle-based formulations and controlled-release systems offer substantial potential for improving both drug retention and targeted delivery, enhancing treatment precision and minimizing systemic toxicity. Continued exploration in these areas, along with optimization of IP administration protocols, is vital for advancing patient outcomes, refining therapeutic strategies, and maximizing the benefits of IP chemotherapy in clinical practice.

腹腔化疗的临床药理学研究。
腹膜转移(PM)常见于卵巢癌、结直肠癌、胰腺癌和胃癌等恶性肿瘤,由于预后不良和全身化疗的有效性有限,给治疗带来了重大挑战。腹膜-血浆屏障减少了药物从血浆到腹腔的有效转移,减少了PM的细胞毒性作用。腹腔内(IP)化疗提供了一种局部方法,使局部药物浓度高,可以提高治疗效果,同时限制全身毒性。三种主要的给药方法:高温腹腔化疗(HIPEC)、加压腹腔气溶胶化疗(PIPAC)和基于导管的IP化疗(CBIP),每种方法都为PM治疗提供了独特的药代动力学(PK)优势。这篇综述提供了IP化疗的药理学原理的全面更新,重点是支持延长IP保留和有效靶向肿瘤的药物特性。讨论了给药变量的影响,强调了它们在优化IP药物暴露中的作用。此外,将评估近期IP治疗中常用药物的PK数据,包括铂基药物、紫杉烷和新型纳米颗粒制剂。虽然PK原理支持IP化疗的施用,但正在进行的临床试验的进一步疗效结果仍在等待中。基于纳米颗粒的配方和控释系统的创新为改善药物保留和靶向给药、提高治疗精度和最小化全身毒性提供了巨大的潜力。在这些领域的持续探索,以及优化IP管理方案,对于提高患者预后,改进治疗策略,并在临床实践中最大化IP化疗的益处至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Drugs
Drugs 医学-毒理学
CiteScore
22.70
自引率
0.90%
发文量
134
审稿时长
3-8 weeks
期刊介绍: Drugs is a journal that aims to enhance pharmacotherapy by publishing review and original research articles on key aspects of clinical pharmacology and therapeutics. The journal includes: Leading/current opinion articles providing an overview of contentious or emerging issues. Definitive reviews of drugs and drug classes, and their place in disease management. Therapy in Practice articles including recommendations for specific clinical situations. High-quality, well designed, original clinical research. Adis Drug Evaluations reviewing the properties and place in therapy of both newer and established drugs. AdisInsight Reports summarising development at first global approval. Moreover, the journal offers additional digital features such as animated abstracts, video abstracts, instructional videos, and podcasts to increase visibility and educational value. Plain language summaries accompany articles to assist readers with some knowledge of the field in understanding important medical advances.
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