CHEMOTHERAPY BY AEROSOL

A new treatment, used in several French hospitals, gives hope to cancer patients: aerosol chemotherapy. This technique makes it possible to directly diffuse drug products into the body and to reduce the side effects of conventional treatment.

A new wind of hope for cancer patients. Invented in 2013 by Professor Marc-André Reymond in Germany, a new type of chemotherapy is developing in France: Intraperitoneal Chemotherapy Pressurized by Aerosols, also called Pipac.

Currently used in seven French hospitals, it allows to spread the components of the chemotherapy by spray, directly in the body of the patients, and not by intravenous. A technique that avoids the side effects related to the passage of the product in the blood.

For now, Pipac is offered in addition to the follow-up of conventional chemotherapy and is only for patients with peritoneal carcinomatosis, a cancer disseminated in the peritoneum. This light membrane covering all the intestines has few vessels, which makes it rather inefficient chemotherapy that passes through the blood.

Once in the block, asleep by general anesthesia, the patient is incised the abdomen a few centimeters. Air is then introduced between two layers of the peritoneum to form a cavity where the chemotherapy is projected in the form of fine droplets. A micro-camera, previously introduced, monitors the smooth running of the operation while surgeons, anesthetist and nurses come out of the operating room, because of the risk of inhalation in case of leakage. The air that forms the pocket is then evacuated and the incisions stitched.

The operation is repeated three times at six-week intervals. With this technique, the distribution of drug agents in the abdomen is homogeneous, while the metastases are particularly well treated. Thus, "this mode of administration allows a reduction of the doses of chemotherapy used up to ten times the conventional doses, which limits the general undesirable effects", indicates on its site the hospital Lyon South, first establishment to propose this technique in France.

Jacques Braud, a 76-year-old patient who was able to meet AFP, is being treated at the Georges-François Leclerc center in Dijon for a cancer of the stomach that has reached two other organs. It benefits from a Pipac in parallel with a classic chemotherapy. A pattern that allows him to suffer no side effects he had experienced during his first chemotherapy. As a result of the latter, he is now paralyzed from the extremities of the feet and hands, which prevents him from practicing hiking, his passion. "Chemo is something terrible, it destroys you," he says.

Several clinical studies have already been conducted in Germany on the subject. One of them has demonstrated a clinical and / or histological response in more than 60% of cases in recurrent patients with peritoneal carcinomatosis of gynecological origin. They exhibited resistance to conventional chemotherapy treatments. But, for want of a wider study, it is currently reserved for patients following palliative treatments, says AFP.

Starting this year, however, the Nantes Cancer Center is preparing a multicenter study involving Dijon. The first objective results should fall within five years. "Tomorrow, we could apply this technique to less affected patients and obtain very good curative results, even preventive," enthuses the news agency Dr. Orry.

Other potentially more potent molecules that are too dangerous to pass into the blood could also be used in the future and, why not, treat other types of cancer, such as bladder and lung cancer, where similar membranes peritoneum exist.

Source : LCI.fr – 13th June 2019