Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
Pressurised intraperitoneal aerosol chemotherapy (PIPAC) for peritoneal metastases: a scoping review of clinical evidence across emerging indications.
СтатьяScoping ReviewОбзорНазвание и аннотация: Перевод пока не подготовлен
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Carpio Carlota Pérez, Lominchar Pablo Lozano, Bayón Luis González
Аннотация
PURPOSE: Pressurised intraperitoneal aerosol chemotherapy (PIPAC) delivers aerosolised cytotoxics directly into the peritoneal cavity under pressure, exploiting physical principles to enhance local drug exposure. Its use is expanding across palliative, neoadjuvant/conversion, and prophylactic settings for peritoneal metastases from multiple primary tumours. This scoping review maps the available clinical evidence by indication and tumour type, and evaluates what the data can and cannot support.
METHODS: We searched PubMed/MEDLINE, OpenAlex, and ClinicalTrials.gov up to March 2026 following PRISMA-ScR guidelines. Studies were categorised by evidence level and clinical scenario. The Newcastle-Ottawa Scale was applied to observational studies. Quantitative synthesis was not performed given heterogeneity across designs, populations, and endpoints.
RESULTS: Ninety-four studies were included (64 primary clinical studies; over 3000 patients, 5000 procedures). Procedural mortality was below 1% and severe complications occurred in 2-3%, though these figures reflect expert centres with selected populations. Histopathological regression (PRGS 1-2) was reported in 56-68% of patients, but this surrogate endpoint remains unvalidated. Median overall survival ranged from 7 to 27 months across tumour types; all figures are from single-arm, uncontrolled studies. No completed trial has included a comparator arm. Two Phase III trials are currently recruiting.
CONCLUSIONS: PIPAC appears feasible and acceptably safe at experienced centres, but its clinical benefit over standard alternatives has not been demonstrated. It should be offered within clinical trials or prospective registries until Phase III results become available.
METHODS: We searched PubMed/MEDLINE, OpenAlex, and ClinicalTrials.gov up to March 2026 following PRISMA-ScR guidelines. Studies were categorised by evidence level and clinical scenario. The Newcastle-Ottawa Scale was applied to observational studies. Quantitative synthesis was not performed given heterogeneity across designs, populations, and endpoints.
RESULTS: Ninety-four studies were included (64 primary clinical studies; over 3000 patients, 5000 procedures). Procedural mortality was below 1% and severe complications occurred in 2-3%, though these figures reflect expert centres with selected populations. Histopathological regression (PRGS 1-2) was reported in 56-68% of patients, but this surrogate endpoint remains unvalidated. Median overall survival ranged from 7 to 27 months across tumour types; all figures are from single-arm, uncontrolled studies. No completed trial has included a comparator arm. Two Phase III trials are currently recruiting.
CONCLUSIONS: PIPAC appears feasible and acceptably safe at experienced centres, but its clinical benefit over standard alternatives has not been demonstrated. It should be offered within clinical trials or prospective registries until Phase III results become available.