ABSTRACT

Introduction: In selected patients with limited peritoneal metastasis (PM), favorable tumor biology, and a good clinical condition, there is an indication for combination of cytoreductive surgery (CRS) and subsequent intravenous (IV) or intraperitoneal (IP) chemotherapy. Compared with IV injection, IP therapy can achieve a high drug concentration within the peritoneal cavity with low systemic toxicity, however, the clinical application of IP chemotherapy is limited by the related abdominal pain, infection, and intolerance.

Areas covered:To improve the anti-tumor efficacy and safety of IP therapy, various pharmaceutical strategies have been developed and show promising potential. This review discusses the specialized modification of traditional drug delivery systems and demonstrates the preparation of customized drug carriers for IP therapy, including chemotherapy and gene therapy. IP therapy has important clinical significance in the treatment of PM using novel anti-tumor agents as well as conventional drugs in new applications.

Expert opinion: Although IP therapy exhibits good performance both in mouse models and in patients with PM in clinical trials, its clinical application remains limited due to the serious side effects and low acceptability. Further investigations, including pharmaceutical strategies, are needed to develop potential IP therapy, focusing on the efficacy and safety thereof.

摘要

简介：在选定的腹膜转移（PM）有限、肿瘤生物学良好且临床状况良好的患者中，有联合减瘤手术（CRS）和随后的静脉（IV）或腹膜内（IP）化疗的指征。与静脉注射相比，IP 治疗可在腹腔内达到高药物浓度，全身毒性低，但 IP 化疗的临床应用受限于相关的腹痛、感染和不耐受。

涵盖领域：为了提高 IP 治疗的抗肿瘤功效和安全性，已经开发了各种药物策略并显示出有希望的潜力。本综述讨论了对传统药物递送系统的专门改造，并展示了为 IP 治疗（包括化疗和基因治疗）制备定制药物载体。IP疗法在使用新型抗肿瘤药物以及新应用中的常规药物治疗PM方面具有重要的临床意义。

专家意见：虽然IP疗法在临床试验中在小鼠模型和PM患者中均表现出良好的性能，但由于副作用严重且可接受性低，其临床应用仍然受到限制。需要进一步研究，包括药物策略，以开发潜在的 IP 疗法，重点是其有效性和安全性。