Essential Questions to ask if you or a loved one has been diagnosed with Mesothelioma ***IMPORTANT***

Local intracavitary chemotherapy for mesothelioma, such as EPIC, NIPEC, and PIPAC

Posted on: March 14, 2024 *Updated on: May 27, 2024

The above chemotherapy types targets the disease more directly compared to traditional systemic chemotherapy. Here’s a brief overview of each type:

EPIC (Early Postoperative Intraperitoneal Chemotherapy)

  • Meaning: This method involves the administration of chemotherapy directly into the peritoneal cavity early after cytoreductive surgery (CRS).
  • Timing: It is applied immediately following CRS, during the early postoperative period.
  • Treats: Specifically designed for peritoneal mesothelioma, aiming to kill any remaining cancer cells post-surgery.
  • Benefits: The direct application can lead to higher concentrations of chemotherapy at the site of the disease with potentially fewer systemic side effects.
  • Risks: May include local complications such as infection or inflammation at the site of administration.

NIPEC (Normothermic Intraperitoneal Chemotherapy)

  • Meaning: This approach involves the circulation of chemotherapy at body temperature within the peritoneal cavity after CRS.
  • Timing: Administered after CRS, similar to EPIC but under normothermic (normal body temperature) conditions.
  • Treats: Peritoneal mesothelioma, targeting residual cancer cells with the goal of preventing recurrence.
  • Benefits: By maintaining a normothermic environment, NIPEC aims to enhance the effectiveness of chemotherapy without the additional stress of hyperthermia.
  • Risks: Potential risks include those associated with the chemotherapy agents used, as well as complications related to the procedure itself.

PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy)

  • Meaning: A newer technique where chemotherapy is nebulized and introduced into the peritoneal cavity under pressure as an aerosol.
  • Timing: Can be used before or in place of CRS, offering a minimally invasive option.
  • Treats: Designed for peritoneal mesothelioma, PIPAC aims to uniformly distribute chemotherapy throughout the peritoneal cavity.
  • Benefits: The pressurized aerosol is thought to enhance penetration of chemotherapy into tumor tissues, potentially improving efficacy.
  • Risks: Includes risks related to the procedure and the effects of chemotherapy, although it’s designed to minimize systemic exposure.

These local chemotherapy techniques reflect ongoing efforts to improve mesothelioma treatment outcomes. Their development and application are based on the premise that direct treatment of the affected area can lead to better control of the disease with potentially fewer side effects than systemic chemotherapy. Clinical trials and ongoing research are crucial for determining the optimal use of these therapies, including their effectiveness, safety, and potential role in standard treatment regimens for mesothelioma.

If you are looking to have one of these surgeries it is best to extensively talk to your family and medical team.