IMR Press / EJGO / Volume 42 / Issue 5 / DOI: 10.31083/j.ejgo4205151
Open Access Review
Pharmacological considerations regarding intraoperative hyperthermic intraperitoneal chemotherapy for ovarian cancer
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1 Department of Surgical Oncology, Medical School of Crete University Hospital, 71110 Heraklion, Greece
2 Department of Biochemistry, Medical School of Crete, 71013 Heraklion, Greece
Eur. J. Gynaecol. Oncol. 2021, 42(5), 1018–1028; https://doi.org/10.31083/j.ejgo4205151
Submitted: 9 August 2021 | Revised: 31 August 2021 | Accepted: 7 September 2021 | Published: 15 October 2021
Abstract

Since ovarian cancer is limited to the peritoneal cavity for a prolonged period during the disease course, intraperitoneal chemotherapy seems a rational treatment option for residual peritoneal disease after cytoreductive surgery. Intraperitoneal when compared with intravenous chemotherapy exhibits a clear pharmacokinetic benefit. Performing intraperitoneal chemotherapy under hyperthermic conditions, as in intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC), may enhance its therapeutic efficacy. Herein, the pharmacological aspects of (hyperthermic) intraperitoneal chemotherapy are discussed, including pharmacokinetics, drug penetration depth into the tumour, drug characteristics, optimal drug choice and the role of hyperthermia. Further clinical pharmacological studies are needed to appraise the optimal drug regimen for HIPEC in patients with primary and recurrent ovarian cancer. Development of new drugs and drug formulations may further improve the efficacy of HIPEC in the future.

Keywords
Ovarian cancer
Intraperitoneal chemotherapy
HIPEC
Hyperthermia
Drug choice
Pharmacokinetics
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