Pharmacological considerations regarding intraoperative hyperthermic intraperitoneal chemotherapy for ovarian cancer

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 can-cer. Development of new drugs and drug formulations may further improve the efficacy of HIPEC in the future.

Ovarian cancer; Intraperitoneal chemotherapy; HIPEC; Hyperthermia; Drug choice; Pharmacokinetics

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