A Palliative Approach to Management of Peritoneal Carcinomatosis and Malignant Ascites

2021 ◽  
Vol 30 (3) ◽  
pp. 475-490
Author(s):  
Josh Bleicher ◽  
Laura A. Lambert
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Malignant Ascites ◽  
Palliative Approach

‘Rollover’ abdominal paracentesis versus standard technique: protocol of a crossover randomized comparative trial

2021 ◽  
Author(s):  
Vishal Sharma ◽  
Daya Krishna Jha ◽  
Manish Rohilla ◽  
Chandan K Das ◽  
Harjeet Singh ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Peritoneal Carcinomatosis ◽  
Comparative Trial ◽  
Standard Technique ◽  
Malignant Ascites ◽  
Primary Objective ◽  
Clinical Trial Registration ◽  
Patient Will ◽  
Abdominal Paracentesis ◽  
Randomized Crossover Study

The sensitivity of single abdominal paracentesis for diagnosis of peritoneal carcinomatosis in patients with malignant ascites is 40–70%. Tumor cells shed from the peritoneum settle preferentially in certain recesses of the peritoneum. We aim to compare the standard technique of abdominal paracentesis versus a rollover technique in a randomized crossover study to assess the cytological yield in patients suspected to have peritoneal carcinomatosis. Each patient will serve as their own control and the outcome assessor (cytopathologist) will be blinded to the method of paracentesis performed. The primary objective will be to compare the tumor cell positivity between the standard paracentesis group and the rollover group among enrolled patients. Clinical Trial registration: CTRI/2020/06/025887 and NCT04232384 .

Effect of catumaxomab treatment in patients with peritoneal carcinomatosis and malignant ascites due to gastrointestinal cancers on survival.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 490-490 ◽  
Author(s):  
M. A. Ströhlein ◽  
M. M. Essing ◽  
M. Hennig ◽  
D. Seimetz ◽  
M. G. Ott ◽  
...  
Keyword(s):  
Overall Survival ◽  
Peritoneal Carcinomatosis ◽  
Malignant Ascites ◽  
Rank Test ◽  
Control Group ◽  
Pivotal Trial ◽  
Treatment Benefit ◽  
Significant Treatment ◽  
Free Survival ◽  
Gi Cancer

490 Background: In 2009 the trifunctional antibody catumaxomab was approved for the intraperitoneal (i.p.) treatment of malignant ascites (MA) in EpCAM-positive carcinomas in Europe. Overall survival (OS) results for gastric cancer patients from the pivotal trial showed a significant treatment benefit of catumaxomab in this patient group. We present the results for the gastrointestinal (GI) cancer subgroup from the pivotal trial including long-term survivors. Methods: A total of 86 patients with MA due to GI cancer (gastric, pancreatic, colon, esophagus, rectum carcinoma) were treated with paracentesis plus catumaxomab (59 patients) vs. paracentesis alone (control, 27 patients). The primary endpoint was puncture-free survival; main secondary endpoints were time to next puncture, overall survival and safety parameters. The endpoints were compared between the catumaxomab and the control group using the Kaplan-Meier method and log-rank test. Analyses were performed for the Full Analysis Set (FAS) and the Safety Set (patients who received at least 1 catumaxomab infusion; 95%). Results: For puncture-free survival, a median of 35 days for catumaxomab vs. 14 days for control was observed (p<0.0001, HR: 0.340 with 95 % CI from 0.194 to 0.597, FAS). Time to next puncture resulted in a median of 118 days vs. 15 days (p<0.0001, HR: 0.161 with 95 % CI from 0.069 to 0.378, FAS). Although the study was not powered nor designed for OS, the difference between treatment and control arm was significant for the Safety Set (median: 61 vs. 44 days, p<0.05, HR: 0.553). ADRs were generally mild to moderate, limited to the treatment period and reversible. Conclusions: I.p. catumaxomab is an EMA-approved treatment for patients suffering from malignant ascites. The positive efficacy results were demonstrated in an advanced stage patient population together with a predictable and manageable safety profile. Patients suffering from peritoneal carcinomatosis with malignant ascites due to GI cancers experience a significant survival benefit from i.p. treatment with catumaxomab. [Table: see text]

scholarly journals Oncolytic vaccinia virus reinvigorates peritoneal immunity and cooperates with immune checkpoint inhibitor to suppress peritoneal carcinomatosis in colon cancer

2020 ◽  
Vol 8 (2) ◽  
pp. e000857
Author(s):  
Yu Seong Lee ◽  
Won Suk Lee ◽  
Chang Woo Kim ◽  
Seung Joon Lee ◽  
Hannah Yang ◽  
...  
Keyword(s):  
Colon Cancer ◽  
T Cells ◽  
Vaccinia Virus ◽  
Peritoneal Carcinomatosis ◽  
Immune Checkpoint ◽  
Malignant Ascites ◽  
Peritoneal Tumor ◽  
Programmed Death ◽  
Ascites Formation ◽  
Anticancer Immunity

BackgroundPeritoneal carcinomatosis (PC) is a common and devastating manifestation of colon cancer and refractory to conventional anticancer therapeutics. During the peritoneal dissemination of colon cancer, peritoneal immunity is nullified by various mechanisms of immune evasion. Here, we employed the armed oncolytic vaccinia virus mJX-594 (JX) to rejuvenate the peritoneal antitumor immune responses in the treatment of PC.MethodsPC model of MC38 colon cancer was generated and intraperitoneally treated with JX and/or anti-programmed cell death protein 1 (PD-1) antibody. The peritoneal tumor burden, vascular leakage, and malignant ascites formation were then assessed. Tumors and peritoneal lavage cells were analyzed by flow cytometry, multiplex tissue imaging, and a NanoString assay.ResultsJX treatment effectively suppressed peritoneal cancer progression and malignant ascites formation. It also restored the peritoneal anticancer immunity by activating peritoneal dendritic cells (DCs) and CD8+ T cells. Moreover, JX selectively infected and killed peritoneal colon cancer cells and promoted the intratumoral infiltration of DCs and CD8+ T cells into peritoneal tumor nodules. JX reinvigorates anticancer immunity by reprogramming immune-related transcriptional signatures within the tumor microenvironment. Notably, JX cooperates with immune checkpoint inhibitors (ICIs), anti-programmed death-1, anti-programmed death-ligand 1, and anti-lymphocyte-activation gene-3 to elicit a stronger anticancer immunity that eliminates peritoneal metastases and malignant ascites of colon cancer compared with JX or ICI alone.ConclusionsIntraperitoneal immunotherapy with JX restores peritoneal anticancer immunity and potentiates immune checkpoint blockade to suppress PC and malignant ascites in colon cancer.

scholarly journals The Anticancer Efficacy of Plasma-Oxidized Saline (POS) in the Ehrlich Ascites Carcinoma Model In Vitro and In Vivo

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 932
Author(s):  
Walison Augusto Silva Brito ◽  
Eric Freund ◽  
Thiago Daniel Henrique do Nascimento ◽  
Gabriella Pasqual-Melo ◽  
Larissa Juliani Sanches ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Anticancer Agent ◽  
Ex Vivo ◽  
Ehrlich Ascites Carcinoma ◽  
Malignant Ascites ◽  
Anticancer Efficacy ◽  
Ehrlich Ascites ◽  
Physical Plasma

Cold physical plasma, a partially ionized gas rich in reactive oxygen species (ROS), is receiving increasing interest as a novel anticancer agent via two modes. The first involves its application to cells and tissues directly, while the second uses physical plasma-derived ROS to oxidize liquids. Saline is a clinically accepted liquid, and here we explored the suitability of plasma-oxidized saline (POS) as anticancer agent technology in vitro and in vivo using the Ehrlich Ascites Carcinoma (EAC) model. EAC mainly grows as a suspension in the peritoneal cavity of mice, making this model ideally suited to test POS as a putative agent against peritoneal carcinomatosis frequently observed with colon, pancreas, and ovarium metastasis. Five POS injections led to a reduction of the tumor burden in vivo as well as in a decline of EAC cell growth and an arrest in metabolic activity ex vivo. The treatment was accompanied by a decreased antioxidant capacity of Ehrlich tumor cells and increased lipid oxidation in the ascites supernatants, while no other side effects were observed. Oxaliplatin and hydrogen peroxide were used as controls and mediated better and worse outcomes, respectively, with the former but not the latter inducing profound changes in the inflammatory milieu among 13 different cytokines investigated in ascites fluid. Modulation of inflammation in the POS group was modest but significant. These results promote POS as a promising candidate for targeting peritoneal carcinomatosis and malignant ascites and suggest EAC to be a suitable and convenient model for analyzing innovative POS approaches and combination therapies.

Sign in / Sign up

Export Citation Format

Share Document