Pressurized Intraperitoneal Aerosol Chemotherapy Enhanced by Electrostatic Precipitation (ePIPAC) for Patients with Peritoneal Metastases.

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new mode of intraperitoneal chemotherapy administration that can potentially be improved by the addition of electrostatic precipitation (ePIPAC). This study aimed to describe the procedural details of ePIPAC and to analyze its safety for patients with nonresectable peritoneal metastasis as well as their tolerance and response to this treatment. This retrospective cohort study included consecutive patients treated with ePIPAC in three centers from April 2019 to April 2020. The toxicities of each patient were assessed using the Common Terminology Criteria for Adverse Events (CTCAE). Complications were documented according to the Clavien classification. Quality of life (QoL) was assessed using EORTC-QLQ-C30, and the peritoneal regression grading score (PRGS) was used to grade histologic responses. Further surrogates for responses were the Peritoneal Cancer Index (PCI), ascites, and symptoms. Overall, 69 patients received 147 ePIPACs with oxaliplatin (n = 34) or cisplatin/doxorubicin (n = 35) mainly for colorectal (n = 25), ovarian (n = 14), and gastric (n = 13) primary cancers. Systemic chemotherapy was used in the treatment of 54 patients (76%). The median electrostatic therapy time was 12 min (range 6-30 min). The overall and major CTCAE toxicity rates were respectively 24.6% and 15.9%. The postoperative complications rate according to Clavien classification was 4.7%. The responses of 22 patients who had three or more ePIPAC treatments were evaluated as follows: PCI (16 vs 14; p = 0.4), ascites (320 vs 98 ml; p = 0.1), and PRGS (2.23 vs 1.73; p = 0.15). The complete (PRGS1) and major (PRGS2) histologic responses at the third ePIPAC were respectively 38.5% and 53.8%. Overall QoL was stable during the first ePIPACs. Repetitive ePIPACs were safe and well tolerated for patients with unresectable peritoneal metastasis

Longueurs d’uretères : sommes-nous tous égaux ?

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Comparison of experimental mouse models of colorectal peritoneal carcinomatosis

International audienceAnimal cancer models play an important role to study the development and progression of peritoneal carcinomatosis and to assess new treatments The aim of this study was to compare 4 mouse models of colorectal peritoneal carcinomatosis (PC) in order to obtain whether a limited or extensive peritoneal carcinomatosis

A syngeneic orthotopic graft murine model for studying nsPEF effects on peritoneal carcinomatosis tumors

International audienceNew immunocompetent cancer models are still needed for the identification and preclinical validation of novel therapeutic targets in colorectal cancer.The aim of this study was to evaluate the implantation rate of CT-26, a type of murine colorectal cancerous cells, on the peritoneum site according to theinjection site. The tumor graft efficiency was compared in 4 grafting methods according to the PCI score and using bioluminescence imaging in a syngeneicimmunocompetent murine strain. Tumoral growth was then followed by bioluminescence, over 15 days post-grafting and nodules that have been exposedto 10 ns pulses were analyzed by histology. In vitro CT-26 cells were also studied by flow cytometry for their sensitivity to nsPEFs and chemotherapeutic drugs(Mitomycin, Oxyplastin): survival, mitochondrial potential and permeabilization. In parallel, peritoneal tumoral tissue was observed by multiphotonmicroscopy in order to evaluate the tumor microenvironment. We observed in vitro a strong dose-dependent effect of nsPEF on cell viability, cell death (DAPI,Annexin V), calcium signaling (Fluo-4) and permeabilization (Yo-Pro). In vivo nsPEF exposure of PM nodules shows also dramatic cells death and proliferativeinhibition, more efficiently and faster than the ones observed after addition of chemotherapeutic drugs (Mitomycin, Oxyplastin)

10 ns PEFs induce a histological response linked to cell death and cytotoxic T-lymphocytes in an immunocompetent mouse model of peritoneal metastasis

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[Adrenal metastasis: survival following surgical resection].

ERMAInternational audienceGOAL: This study aims to determine the post-surgical survival after resection of adrenal metastasis from extra-adrenal primary cancers. PATIENTS AND METHODS: A retrospective study of sixteen patients undergoing surgery for adrenal metastasis between 1995 and 2005 analyzed age, type of primary cancer, interval to detection of adrenal metastasis, type of surgery performed, and survival (Kaplan-Meier curve). RESULTS: The study included 10 men and 6 women with a mean age of 55.5 years (25-74). Adrenal metastasis causes no clinical signs or symptoms. Diagnosis was made on the basis of CT scan in 12 cases and PET scan in 4 cases. The primary cancer site was lung (6), kidney (3), melanoma (2), colorectum (2), esophagus (1), pancreas (1), and B-cell lymphoma (1). Metastasis was confined to the adrenal in 7 cases and associated with other-site metastasis in 9. The interval from diagnosis of the primary cancer to detection of the adrenal metastasis ranged from 9 months to 11 years. Surgery consisted of radical resection in 5 cases, metastasectomy in 10 cases, and biopsy in one case. The overall survival was 12 months (range 2-120 months); when the diagnosis of the metastasis was synchronous with that of the primary, survival was just 8 months. CONCLUSION: The survival after surgery for adrenal metastasis is poor; it is even more dismal when the metastasis is diagnosed synchronously with the primary tumor. Surgical management depends on the primary neoplasm and the extent of metastases

Nanosecond pulses electric field (nsPEF) treatment for peritoneal metastases from colorectal cancer

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