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Quénet F, Carrère S, Sgarbura O. [Contribution of intraperitoneal chemotherapy in the treatment of colorectal peritoneal carcinoma. HIPEC, PIPAC, state of the art and future directions]. Bull Cancer 2024; 111:285-290. [PMID: 38331695 DOI: 10.1016/j.bulcan.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 02/10/2024]
Abstract
After more than a decade of good results using the combination of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal carcinosis of colorectal origin, the PRODIGE7 study, which specifically evaluated the role of HIPEC, failed to show any superiority in terms of overall and disease-free survival for the CRS+HIPEC combination compared with CRS alone. This study constituted a radical change in the knowledge and therapeutic attitudes observed to date. After reviewing the literature and the consensus of national and international experts, a synthesis is provided, together with an outlook on the questions raised and the therapeutic trials and innovations of the near future. An analysis of recent advances due to the advent of a new technique, PIPAC, is also proposed, as well as a review of current therapeutic trials in this field.
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Affiliation(s)
- François Quénet
- Service de chirurgie oncologique, ICM Montpellier, 208, avenue des Apothicaires, 34000 Montpellier, France.
| | - Sébastien Carrère
- Service de chirurgie oncologique, ICM Montpellier, 208, avenue des Apothicaires, 34000 Montpellier, France
| | - Olivia Sgarbura
- Service de chirurgie oncologique, ICM Montpellier, 208, avenue des Apothicaires, 34000 Montpellier, France
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2
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Braet H, Fransen PP, Mariën R, Lollo G, Ceelen W, Vervaet C, Balcaen L, Vanhaecke F, Vanhove C, van der Vegte S, Gasthuys E, Vermeulen A, Dankers PYW, De Smedt SC, Remaut K. CO 2-Driven Nebulization of pH-Sensitive Supramolecular Polymers for Intraperitoneal Hydrogel Formation and the Treatment of Peritoneal Metastasis. ACS APPLIED MATERIALS & INTERFACES 2023; 15:49022-49034. [PMID: 37819736 DOI: 10.1021/acsami.3c11274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Because peritoneal metastasis (PM) from ovarian cancer is characterized by non-specific symptoms, it is often diagnosed at advanced stages. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) can be considered a promising drug delivery method for unresectable PM. Currently, the efficacy of intraperitoneal (IP) drug delivery is limited by the off-label use of IV chemotherapeutic solutions, which are rapidly cleared from the IP cavity. Hence, this research aimed to improve PM treatment by evaluating a nanoparticle-loaded, pH-switchable supramolecular polymer hydrogel as a controlled release drug delivery system that can be IP nebulized. Moreover, a multidirectional nozzle was developed to allow nebulization of viscous materials such as hydrogels and to reach an even IP gel deposition. We demonstrated that acidification of the nebulized hydrogelator solution by carbon dioxide, used to inflate the IP cavity during laparoscopic surgery, stimulated the in situ gelation, which prolonged the IP hydrogel retention. In vitro experiments indicated that paclitaxel nanocrystals were gradually released from the hydrogel depot formed, which sustained the cytotoxicity of the formulation for 10 days. Finally, after aerosolization of this material in a xenograft model of PM, tumor progression could successfully be delayed, while the overall survival time was significantly increased compared to non-treated animals.
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Affiliation(s)
- Helena Braet
- Department of Pharmaceutics, Ghent University, Ghent 9000, Belgium
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
| | | | - Remco Mariën
- Department of Pharmaceutics, Ghent University, Ghent 9000, Belgium
| | - Giovanna Lollo
- Laboratoire d'Automatique, de Génie des Procédés et de Génie Pharmaceutique (LAGEPP), Université Claude Bernard Lyon 1, Lyon 69622, France
| | - Wim Ceelen
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent 9000, Belgium
| | - Chris Vervaet
- Department of Pharmaceutics, Ghent University, Ghent 9000, Belgium
| | - Lieve Balcaen
- Department of Chemistry, Ghent University, Ghent 9000, Belgium
| | - Frank Vanhaecke
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
- Department of Chemistry, Ghent University, Ghent 9000, Belgium
| | - Christian Vanhove
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
- Department of Electronics and Information Systems, Ghent University, Ghent 9000, Belgium
| | | | - Elke Gasthuys
- Department of Bioanalysis, Ghent University, Ghent 9000, Belgium
| | - An Vermeulen
- Department of Bioanalysis, Ghent University, Ghent 9000, Belgium
| | - Patricia Y W Dankers
- Department of Biomedical Engineering and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven 5600 MB, The Netherlands
| | - Stefaan C De Smedt
- Department of Pharmaceutics, Ghent University, Ghent 9000, Belgium
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
| | - Katrien Remaut
- Department of Pharmaceutics, Ghent University, Ghent 9000, Belgium
- CRIG - Cancer Research Institute Ghent, Ghent 9000, Belgium
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3
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Braet H, Andretto V, Mariën R, Yücesan B, van der Vegte S, Haegebaert R, Lollo G, De Smedt SC, Remaut K. The effect of electrostatic high pressure nebulization on the stability, activity and ex vivo distribution of ionic self-assembled nanomedicines. Acta Biomater 2023; 170:318-329. [PMID: 37598790 DOI: 10.1016/j.actbio.2023.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 08/22/2023]
Abstract
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is applied to treat unresectable peritoneal metastasis (PM), an advanced, end-stage disease with a poor prognosis. Electrostatic precipitation of the aerosol (ePIPAC) is aimed at improving the intraperitoneal (IP) drug distribution and tumor penetration. Also, the combination of nanoparticles (NPs) as drug delivery vehicles and IP aerosolization as administration method has been proposed as a promising tool to treat PM. There is currently limited knowledge on how electrostatic precipitation (ePIPAC) and high pressure nebulization (PIPAC) affects the performance of electrostatically formed complexes. Therefore, the stability, in vitro activity and ex vivo distribution and tissue penetration of negatively charged cisPt-pArg-HA NPs and positively charged siRNA-RNAiMAX NPs was evaluated following PIPAC and ePIPAC. Additionally, a multidirectional Medspray® nozzle was developed and compared with the currently used Capnopen® nozzle. For both NP types, PIPAC and ePIPAC did not negatively influence the in vitro activity, although limited aggregation of siRNA-RNAiMAX NPs was observed following nebulization with the Capnopen®. Importantly, ePIPAC was linked to a more uniform distribution and higher tissue penetration of the NPs aerosolized by both nozzles, independent on the NPs charge. Finally, compared to the Capnopen®, an increased NP deposition was observed at the top of the ex vivo model following aerosolization with the Medspray® nozzle, which indicates that this device possesses great potential for IP drug delivery purposes. STATEMENT OF SIGNIFICANCE: Aerosolized drug delivery in the peritoneal cavity holds great promise to treat peritoneal cancer. In addition, electrostatic precipitation of the aerosol to the peritoneal tissue is aimed at improving the drug distribution and tumor penetration. The combination of nanoparticles (NPs), which are nano-sized drug delivery vehicles, and aerosolization has been proposed as a promising tool to treat peritoneal cancer. However, there is currently limited knowledge on how electrostatic precipitation and aerosolization affect the performance of electrostatically formed NPs. Therefore, the stability, activity, distribution and penetration of negatively and positively charged NPs was evaluated after aerosolization and electrostatic precipitation. Additionally, to further optimize the local drug distribution, a multidirectional spray nozzle was developed and compared with the currently used nozzle.
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Affiliation(s)
- Helena Braet
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Valentina Andretto
- Laboratoire d'Automatique, de Génie des Procédés et de Génie Pharmaceutique (LAGEPP), Université Claude Bernard Lyon 1, Lyon, France
| | - Remco Mariën
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | - Beyza Yücesan
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | | | - Ragna Haegebaert
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Giovanna Lollo
- Laboratoire d'Automatique, de Génie des Procédés et de Génie Pharmaceutique (LAGEPP), Université Claude Bernard Lyon 1, Lyon, France
| | - Stefaan C De Smedt
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Katrien Remaut
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium.
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4
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Braet H, Fransen PP, Chen Y, Van Herck S, Mariën R, Vanhoorne V, Ceelen W, Madder A, Ballet S, Hoogenboom R, De Geest B, Hoorens A, Dankers PYW, De Smedt SC, Remaut K. Smart hydrogels delivered by high pressure aerosolization can prevent peritoneal adhesions. J Control Release 2023; 362:138-150. [PMID: 37619864 DOI: 10.1016/j.jconrel.2023.08.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
Postoperative peritoneal adhesions occur in the majority of patients undergoing intra-abdominal surgery and are one of the leading causes of hospital re-admission. There is an unmet clinical need for effective anti-adhesive biomaterials, which can be applied evenly across the damaged tissues. We examined three different responsive hydrogel types, i.e. a thermosensitive PLGA-PEG-PLGA, a pH responsive UPy-PEG and a shear-thinning hexapeptide for this purpose. More specifically, their potential to be homogeneously distributed in the peritoneal cavity by high pressure nebulization and prevent peritoneal adhesions was evaluated. Solutions of each polymer type could be successfully nebulized while retaining their responsive gelation behavior in vitro and in vivo. Furthermore, none of the polymers caused in vitro toxicity on SKOV3-IP2 cells. Following intraperitoneal administration, both the PLGA-PEG-PLGA and the hexapeptide hydrogels resulted in local inflammation and fibrosis and failed in preventing peritoneal adhesions 7 days after adhesion induction. In contrast, the pH sensitive UPy-PEG formulation was well tolerated and could significantly reduce the formation of peritoneal adhesions, even outperforming the commercially available Hyalobarrier® as positive control. To conclude, local nebulization of the bioresponsive UPy-PEG hydrogel can be considered as a promising approach to prevent postsurgical peritoneal adhesions.
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Affiliation(s)
- Helena Braet
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | | | - Yong Chen
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Simon Van Herck
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Remco Mariën
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | | | - Wim Ceelen
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Annemieke Madder
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Organic and Macromolecular Chemistry, Ghent University, Ghent, Belgium
| | - Steven Ballet
- Departments of Chemistry and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Richard Hoogenboom
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Organic and Macromolecular Chemistry, Ghent University, Ghent, Belgium
| | - Bruno De Geest
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Anne Hoorens
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Patricia Y W Dankers
- Department of Biomedical Engineering and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Stefaan C De Smedt
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Katrien Remaut
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium.
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5
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Baggaley AE, Lafaurie GBRC, Tate SJ, Boshier PR, Case A, Prosser S, Torkington J, Jones SEF, Gwynne SH, Peters CJ. Pressurized intraperitoneal aerosol chemotherapy (PIPAC): updated systematic review using the IDEAL framework. Br J Surg 2022; 110:10-18. [PMID: 36056893 PMCID: PMC10364525 DOI: 10.1093/bjs/znac284] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/28/2022] [Accepted: 07/19/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Alice E Baggaley
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
| | | | - Sophia J Tate
- Department of Anaesthesia, Swansea Bay University Health Board, Swansea, UK
| | - Piers R Boshier
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
| | - Amy Case
- Department of Cancer Services, Swansea Bay University Health Board, Swansea, UK
| | - Susan Prosser
- Department of Library Services, Swansea Bay University Health Board, Swansea, UK
| | - Jared Torkington
- Department of Surgery, University Hospital of Wales, Cardiff, UK
| | - Sadie E F Jones
- Department of Obstetrics and Gynaecology, University Hospital of Wales, Cardiff, UK
| | - Sarah H Gwynne
- Department of Cancer Services, Swansea Bay University Health Board, Swansea, UK
| | - Christopher J Peters
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
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Theoretical analysis for the fluctuation in the electric parameters of the electroporated cells before and during the electrofusion. Med Biol Eng Comput 2022; 60:3585-3600. [DOI: 10.1007/s11517-022-02683-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/27/2022] [Indexed: 11/05/2022]
Abstract
AbstractAn electric pulse with a sufficient amplitude can lead to electroporation of intracellular organelles. Also, the electric field can lead to electrofusion of the neighboring cells. In this paper, a finite element mathematical model was used to simulate the distribution, radius, and density of the pores. We simulated a mathematical model of the two neighbor cells to analyze the fluctuation in the electroporation parameters before the electrofusion under the ultra-shorted electric field pulse (i.e., impulse signal) for each cell separately and after the electrofusion under the ultra-shorted pulse. The analysis of the temporal and spatial distribution can lead to improving the mathematical models that are used to analyze both electroporation and electrofusion. The study combines the advantages of the nanosecond pulse to avoid the effect of the cell size on the electrofusion and the large-pore radius at the contact point between the cells.
Graphical abstract
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7
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Min JWS, Saeed N, Coene A, Adriaens M, Ceelen W. Electromotive Enhanced Drug Administration in Oncology: Principles, Evidence, Current and Emerging Applications. Cancers (Basel) 2022; 14:4980. [PMID: 36291762 PMCID: PMC9599758 DOI: 10.3390/cancers14204980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 08/30/2023] Open
Abstract
Local-regional administration of cytotoxic drugs is an important adjunct to systemic chemotherapy amongst cancer patients. It allows for targeted delivery of agents at high concentration to target sites while minimizing systemic side effects. Despite the pharmacokinetic advantages of the local-regional approach, drug transport into tumor nodules remains limited due to the biophysical properties of these tissues. Electromotive enhanced drug administration (EMDA) represents a potential solution to overcome challenges in local drug transport by applying electric currents. Through electrokinetic phenomena of electromigration, electroosmosis and electroporation, electric currents have been shown to improve drug penetration and distribution in a wide variety of clinical applications. Amongst patients with non-muscular invasive bladder cancer (NMIBC) and basal and squamous cell skin cancers, EMDA has been successfully adopted and proven efficacious in several pre-clinical and clinical studies. Its application in ophthalmological and other conditions has also been explored. This review provides an overview of the underlying principles and factors that govern EMDA and discusses its application in cancer patients. We also discuss novel EMDA approaches in pre-clinical studies and explore future opportunities of developments in this field.
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Affiliation(s)
- Jolene Wong Si Min
- Department of GI Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | - Nidda Saeed
- Department of GI Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | - Annelies Coene
- Department of Electromechanical, Systems and Metal Engineering, Faculty of Engineering and Architecture, Ghent University, 9000 Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium
| | - Mieke Adriaens
- Department of Chemistry, Faculty of Sciences, Ghent University, 9000 Ghent, Belgium
| | - Wim Ceelen
- Department of GI Surgery, Ghent University Hospital, 9000 Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium
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Yakubu DG, Abdulhameed M, Adamu GT, Hassan U, Kaurangini ML. Construction of the exact solution of blood flow of oldroyd-B fluids through arteries with effects of fractional derivative magnetic field and heat transfer. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422500683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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9
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Sreedaran B, Ponnuswamy V. A two-dimensional mathematical model of tumor angiogenesis with CD147. Proc Inst Mech Eng H 2022; 236:1009-1022. [DOI: 10.1177/09544119221093845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tumor angiogenesis is the tumor’s inherent blood supply system which is crucial for the growth of tumor. Extracellular Matrix Metallo Proteinases Inducer (EMMPRIN)/Cluster of Differentiation 147 (CD147) is found in high levels on tumor surfaces. This study focuses on these elevated levels of CD147 and the effect it has on tumor angiogenesis. The present article develops a Two-Dimensional Mathematical Model of Tumor Angiogenesis taking into account the CD147 molecule. The effects of CD147 on Tumor Angiogenesis Factors (TAFs), fibronectin and Matrix Metallo Proteinases (MMPs) are also incorporated. The results have been obtained through COMSOL Multiphysics 5.4 software. The results show that CD147 is responsible for swifter angiogenesis, calling for targeting this molecule in anti-angiogenic strategies. The present model is validated with the existing theoretical and experimental results.
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Affiliation(s)
- Bhooma Sreedaran
- Department of Mathematics, Anna University, Chennai, Tamil Nadu, India
| | - Vimala Ponnuswamy
- Department of Mathematics, Anna University, Chennai, Tamil Nadu, India
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10
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Optimization of intraperitoneal aerosolized drug delivery using computational fluid dynamics (CFD) modeling. Sci Rep 2022; 12:6305. [PMID: 35428819 PMCID: PMC9012796 DOI: 10.1038/s41598-022-10369-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/04/2022] [Indexed: 01/03/2023] Open
Abstract
Intraperitoneal (IP) aerosolized anticancer drug delivery was recently introduced in the treatment of patients with peritoneal metastases. However, little is known on the effect of treatment parameters on the spatial distribution of the aerosol droplets in the peritoneal cavity. Here, computational fluid dynamics (CFD) modeling was used in conjunction with experimental validation in order to investigate the effect of droplet size, liquid flow rate and viscosity, and the addition of an electrostatic field on the homogeneity of IP aerosol. We found that spatial distribution is optimal with small droplet sizes (1–5 µm). Using the current clinically used technology (droplet size of 30 µm), the optimal spatial distribution of aerosol is obtained with a liquid flow rate of 0.6 mL s−1. Compared to saline, nebulization of higher viscosity liquids results in less homogeneous aerosol distribution. The addition of electrostatic precipitation significantly improves homogeneity of aerosol distribution, but no further improvement is obtained with voltages higher than 6.5 kV. The results of the current study will allow to choose treatment parameters and settings in order to optimize spatial distribution of IP aerosolized drug, with a potential to enhance its anticancer effect.
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11
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Sgarbura O, Eveno C, Alyami M, Bakrin N, Guiral DC, Ceelen W, Delgadillo X, Dellinger T, Di Giorgio A, Kefleyesus A, Khomiakov V, Mortensen MB, Murphy J, Pocard M, Reymond M, Robella M, Rovers KP, So J, Somashekhar SP, Tempfer C, Van der Speeten K, Villeneuve L, Yong WP, Hübner M. Consensus statement for treatment protocols in pressurized intraperitoneal aerosol chemotherapy (PIPAC). Pleura Peritoneum 2022; 7:1-7. [PMID: 35602919 PMCID: PMC9069497 DOI: 10.1515/pp-2022-0102] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/02/2022] [Indexed: 12/11/2022] Open
Abstract
Objectives Safe implementation and thorough evaluation of new treatments require prospective data monitoring and standardization of treatments. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a promising alternative for the treatment of patients with peritoneal disease with an increasing number of suggested drug regimens. The aim was to reach expert consensus on current PIPAC treatment protocols and to define the most important research topics. Methods The expert panel included the most active PIPAC centers, organizers of PIPAC courses and principal investigators of prospective studies on PIPAC. A comprehensive literature review served as base for a two-day hybrid consensus meeting which was accompanied by a modified three-round Delphi process. Consensus bar was set at 70% for combined (strong and weak) positive or negative votes according to GRADE. Research questions were prioritized from 0 to 10 (highest importance). Results Twenty-two out of 26 invited experts completed the entire consensus process. Consensus was reached for 10/10 final questions. The combination of doxorubicin (2.1 mg/m2) and cisplatin (10.5 mg/m2) was endorsed by 20/22 experts (90.9%). 16/22 (72.7%) supported oxaliplatin at 120 with potential reduction to 90 mg/m2 (frail patients), and 77.2% suggested PIPAC-Ox in combination with 5-FU. Mitomycin-C and Nab-paclitaxel were favoured as alternative regimens. The most important research questions concerned PIPAC conditions (n=3), standard (n=4) and alternative regimens (n=5) and efficacy of PIPAC treatment (n=2); 8/14 were given a priority of ≥8/10. Conclusions The current consensus should help to limit heterogeneity of treatment protocols but underlines the utmost importance of further research.
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Affiliation(s)
- Olivia Sgarbura
- Department of Surgical Oncology , Cancer Institute of Montpellier, University of Montpellier , Montpellier , France
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194 , Université de Montpellier, Institut régional du Cancer de Montpellier , Montpellier , France
| | - Clarisse Eveno
- Department of Digestive and Oncological Surgery , University of Lille, Claude Huriez University Hospital , Lille , France
| | - Mohammad Alyami
- Department of General Surgery and Surgical Oncology , Oncology Center, King Khalid Hospital , Najran , Saudi Arabia
| | - Naoual Bakrin
- Department of General Surgery & Surgical Oncology , Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon , Pierre-Bénite , France
- Lyon University 1, EA 3738 CICLY , Lyon , France
| | - Delia Cortes Guiral
- Department of General Surgery and Surgical Oncology , Oncology Center, King Khalid Hospital , Najran , Saudi Arabia
| | - Wim Ceelen
- Department of GI Surgery , Ghent University Hospital , Ghent , Belgium
| | - Xavier Delgadillo
- Centre Médico Chirurgical Volta , Unité Spécialisée de Chirurgie , La Chaux-de-Fonds , Switzerland
| | - Thanh Dellinger
- Department of Gynecologic Oncology , City of Hope National Medical Center , Duarte , CA , USA
| | - Andrea Di Giorgio
- Peritoneal and Retroperitoneal Surgical Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS , Rome , Italy
| | - Amaniel Kefleyesus
- Department of General Surgery & Surgical Oncology , Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon , Pierre-Bénite , France
- Department of Visceral Surgery , Lausanne University Hospital CHUV, University of Lausanne (UNIL) , Lausanne , Switzerland
| | - Vladimir Khomiakov
- P.A. Hertsen Moscow Research Oncological Institute – Branch of the National Medical Research Center of Radiology , Moscow , Russia
| | - Michael Bau Mortensen
- Department of Surgery , Odense Pancreas Center (OPAC) & Odense PIPAC Center (OPC), Odense University Hospital , Odense , Denmark
| | - Jamie Murphy
- Academic Surgical Unit , Imperial College Healthcare NHS Trust , London , UK
| | - Marc Pocard
- Université de Paris, INSERM, U1275 CAP Paris-Tech , Paris , France
- Hepato-Biliary-Pancreatic Gastrointestinal Surgery and Liver Transplantation , Pitié Salpêtrière Hospital, AP-HP , Paris , France
| | - Marc Reymond
- Department of Surgery , University of Tübingen , Tübingen , Germany
| | - Manuela Robella
- Unit of Surgical Oncology , Candiolo Cancer Institute-FPO, IRCCS , Turin , Italy
| | - Koen P. Rovers
- Department of Surgery , Catharina Cancer Institute , Eindhoven , The Netherlands
| | - Jimmy So
- Division of Surgical Oncology , National University Cancer Institute , Singapore , Singapore
| | - S. P. Somashekhar
- Department of Surgical Oncology , Manipal Comprehensive Cancer Center, Manipal Hospital , Bangalore , India
| | - Clemens Tempfer
- Department of Obstetrics and Gynecology and Therapy Center for Peritoneal Carcinomatosis , Marien Hospital Herne, Ruhr-Universität Bochum , Herne , Germany
| | | | - Laurent Villeneuve
- Lyon University 1, EA 3738 CICLY , Lyon , France
- Department of Public Health , Clinical Research and Epidemiology, Hospices Civils de Lyon , Lyon , France
| | - Wei Peng Yong
- Cancer Science Institute of Singapore , National University of Singapore , Singapore , Singapore
| | - Martin Hübner
- Department of Visceral Surgery , Lausanne University Hospital CHUV, University of Lausanne (UNIL) , Lausanne , Switzerland
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12
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Discrete element simulation for mixing performances and power consumption in a twin-blade planetary mixer with non-cohesive particles. ADV POWDER TECHNOL 2022. [DOI: 10.1016/j.apt.2022.103437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Slug Flow Hydrodynamics Modeling for Gas–Liquid Two-Phase Flow in a Pipe. ENERGIES 2022. [DOI: 10.3390/en15020533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Gas–liquid flow in a pipeline is a very common. Slug two-phase flow is dominated in the case of slightly upward flow (+0.25°) and considered to be the comprehensive flow configuration, and can be in close contact with all the other flow patterns. The models of different flow patterns can be unified. Precise prediction of the slug flow is crucial for proper design and operation. In this paper, we develop hydrodynamics unified modeling for gas–liquid two-phase slug flow, and the bubble and droplet entrainment is optimized. For the important parameters (wall and interfacial friction factors, slug translational velocity and average slug length), the correlations of these parameters are optimized. Furthermore, the related parameters for liquid droplet and gas bubble entrainment are given. Accounting for the gas–liquid interface shape, hydrodynamics models, i.e., the flat interface model (FIM) and the double interface model (DIM), of liquid film in the slug body are applied and compared with the experimental data. The calculated results show that the predictions for the liquid holdup and pressure gradient of the DIM agree with experimental data better than those of the FIM. A comparison between the available experimental results and Zhang’s model calculations shows that the DIM model correctly describes the slug dynamics in gas–liquid pipe flow.
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Hübner M, Alyami M, Villeneuve L, Cortés-Guiral D, Nowacki M, So J, Sgarbura O. Consensus guidelines for pressurized intraperitoneal aerosol chemotherapy: Technical aspects and treatment protocols. Eur J Surg Oncol 2021; 48:789-794. [PMID: 34785087 DOI: 10.1016/j.ejso.2021.10.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/22/2021] [Accepted: 10/28/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is increasingly used to treat patients with peritoneal cancer. A recent survey demonstrated considerable diversification of current practice of PIPAC raising issues of concern also regarding safety and efficacy. The study aim was to reach consensus on best practice of PIPAC treatment. METHODS Current practice was critically discussed during an expert meeting and the available evidence was scrutinized to elaborate a 33-item closed-ended questionnaire. All active PIPAC centers were then invited to participate in an online two-round Delphi process with 3 reminders at least. Consensus was defined a priori as >70% agreement for a minimal response rate of 70%. RESULTS Forty-nine out of 57 invited PIPAC centers participated in Delphi 1 and 2 (86%). Overall, there was agreement for 21/33 items. Consensus was reached for important aspects like advanced OR ventilation system (91.8%), remote monitoring (95.9%), use of the PRGS (85.7%) and use of a safety checklist (98%). The drug regimens oxaliplatin (87.8%) and cisplatin/doxorubicin (81.6%) were both confirmed by the expert panel. Important controversies included number and location of Biopsies during repeated PIPAC and the combination of PIPAC with additional surgical procedures. CONCLUSION This consensus statement aims to allow for safe and efficacious PIPAC treatment and to facilitate multi-center analyses of the results. Additional preclinical and clinical studies are needed to resolve the remaining controversies.
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Affiliation(s)
- Martin Hübner
- Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Switzerland.
| | - Mohammad Alyami
- Department of General Surgery and Surgical Oncology, Oncology Center, King Khalid Hospital, Najran, Saudi Arabia
| | - Laurent Villeneuve
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Recherche et d'Epidémiologie Cliniques, Pierre-Bénite, F-69495, France; Université Lyon-1, EA 3738 CICLY, Oullins Cedex, F-69921, France
| | - Delia Cortés-Guiral
- Department of General Surgery and Surgical Oncology, Oncology Center, King Khalid Hospital, Najran, Saudi Arabia
| | - Maciej Nowacki
- Chair and Department of Surgical Oncology, Ludwik Rydygier's Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun. Oncology Centre-Prof. Franciszek Łukaszczyk Memorial Hospital in Bydgoszcz. Bydgoszcz, Poland
| | - Jimmy So
- National University Hospital, Singapore
| | - Olivia Sgarbura
- Department of Surgical Oncology, Cancer Institute Montpellier (ICM), Montpellier, France; University of Montpellier, France
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Braet H, Rahimi-Gorji M, Debbaut C, Ghorbaniasl G, Van Walleghem T, Cornelis S, Cosyns S, Vervaet C, Willaert W, Ceelen W, De Smedt SC, Remaut K. Exploring High Pressure Nebulization of Pluronic F127 Hydrogels for Intraperitoneal Drug Delivery. Eur J Pharm Biopharm 2021; 169:134-143. [PMID: 34634467 DOI: 10.1016/j.ejpb.2021.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/29/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022]
Abstract
Peritoneal metastasis is an advanced cancer type which can be treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC). Here, chemotherapeutics are nebulized under high pressure in the intraperitoneal (IP) cavity to obtain a better biodistribution and tumor penetration. To prevent the fast leakage of chemotherapeutics from the IP cavity, however, nebulization of controlled release formulations is of interest. In this study, the potential of the thermosensitive hydrogel Pluronic F127 to be applied by high pressure nebulization is evaluated. Therefore, aerosol formation is experimentally examined by laser diffraction and theoretically simulated by computational fluid dynamics (CFD) modelling. Furthermore, Pluronic F127 hydrogels are subjected to rheological characterization after which the release of fluorescent model nanoparticles from the hydrogels is determined. A delicate equilibrium is observed between controlled release properties and suitability for aerosolization, where denser hydrogels (20% and 25% w/v Pluronic F127) are able to sustain nanoparticle release up to 30 hours, but cannot effectively be nebulized and vice versa. This is demonstrated by a growing aerosol droplet size and exponentially decreasing aerosol cone angle when Pluronic F127 concentration and viscosity increase. Novel nozzle designs or alternative controlled release formulations could move intraperitoneal drug delivery by high pressure nebulization forward.
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Affiliation(s)
- Helena Braet
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium; Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium.
| | - Mohammad Rahimi-Gorji
- Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium; IBiTech - bioMMeda, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Charlotte Debbaut
- Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium; IBiTech - bioMMeda, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Ghader Ghorbaniasl
- Department of Mechanical Engineering, Vrije Universiteit Brussel, Pleinlaan 2, Brussels, 1050, Belgium.
| | - Thibault Van Walleghem
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium
| | - Senne Cornelis
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium
| | - Sarah Cosyns
- Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Chris Vervaet
- Laboratory of Pharmaceutical Technology, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium.
| | - Wouter Willaert
- Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Wim Ceelen
- Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium; Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
| | - Stefaan C De Smedt
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium; Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium.
| | - Katrien Remaut
- Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Ottergemsesteenweg 460, Ghent, 9000, Belgium; Cancer Research Institute Ghent (CRIG), Ghent University, Corneel Heymanslaan 10, Ghent, 9000 Belgium.
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Wang Q, Tian H, Dang X, Pan J, Gao Y, Xu Q, Lin Z, Yao Y. Temperature Distribution Simulation, Prediction and Sensitivity Analysis of Orthogonal Cutting of Cortical Bone. Proc Inst Mech Eng H 2021; 236:103-120. [PMID: 34617494 DOI: 10.1177/09544119211049869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Bone cutting plays an important role in spine surgical operations. The power devices with high speed employing in bone cutting usually leads to high cutting temperature of the bone tissue. This high temperature control is important in improving cutting surface quality and optimizing the cutting parameters. In this paper, the bone-cutting model was appropriately simplified for finite element (FE) based modeling of 2D orthogonal cutting to discuss the change law of cutting temperature of cortical bones for cervical vertebra, and to study the orthogonal cutting mechanism of the anisotropic cortical bone, a 3D FE simulation model had been also established in which longitudinal, vertical, and transversal cutting types were accomplished to investigate the effect of osteons orientation. Secondly, this response surface method was used to regress the simulation results, and establishes the prediction model of maximum temperature on cutting depth, cutting speed, and feed speed. Then, the Sobol method was used to analyze the sensitivity of the milling temperature prediction mathematical model parameters, in order to clarify and quantitatively analyze the influence of input milling parameters on the output milling temperature. Finally, the cutting temperatures obtained with the simulations were compared with the corresponding experimental results obtained from the bone milling tests. This study verifies the influence of key variables and the cutting parameters on thermo mechanical behavior of the bone cutting. The obtained cutting temperature distribution for the bone surfaces could be employed to establish a theoretical foundation for research on thermal damage control of bone tissues.
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Affiliation(s)
- Quanwei Wang
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, Shandong, China
| | - Heqiang Tian
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, Shandong, China
| | | | - Jingbo Pan
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, Shandong, China
| | - Yu Gao
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, Shandong, China
| | - Qian Xu
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, Shandong, China
| | - Zhe Lin
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, Shandong, China
| | - Yanan Yao
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, Shandong, China
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Lurvink RJ, Van der Speeten K, Rovers KP, de Hingh IHJT. The emergence of pressurized intraperitoneal aerosol chemotherapy as a palliative treatment option for patients with diffuse peritoneal metastases: a narrative review. J Gastrointest Oncol 2021; 12:S259-S270. [PMID: 33968442 DOI: 10.21037/jgo-20-497] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is an emerging palliative treatment for patients with unresectable peritoneal metastases. Potential advantages of PIPAC over current treatment options are a homogeneous intraperitoneal distribution, low local and systemic toxicity, and enhanced tumour penetration. Given these possible benefits, PIPAC is increasingly implemented in many centres worldwide. Scientific research into PIPAC is currently available from in vitro/in vivo/in animal studies, retrospective cohorts in humans, and phase I and II studies in humans. There are no results from randomised trials comparing PIPAC with conventional treatment, such as palliative systemic therapy. This narrative review aimed to provide an overview of the currently available literature on PIPAC. In general, repetitive PIPAC was feasible and safe for patients and operating room personnel. Primary and secondary non-access rates varied from 0-17% and 0-15%, respectively. Iatrogenic bowel injury was observed in 0-3% of PIPAC procedures. CTCAE grade 1-2 complications were common, mostly consisting of abdominal pain, nausea, vomiting, and fatigue. CTCAE grade 3-4 complications were uncommon, occurring on 0-15% of PIPAC procedures. Post-operative mortality rates of 0-2% were reported. The risk of occupational exposure to cytotoxic drugs was very low when strict safety guidelines were followed. Clinical heterogeneity was high in most studies, since, in general, patients with unresectable peritoneal metastases from a variety of primary tumours were included. Also, patients received either PIPAC monotherapy or PIPAC combined with concomitant systemic therapy, and were able to receive PIPAC in any line of palliative treatment. Since the results were generally not stratified for these three important factors, this severely complicates the interpretation of results. Based on the current literature, PIPAC may be regarded as a promising palliative treatment option in patients with diffuse peritoneal metastases. Initial results show that it is feasible and safe. However, well designed and (ideally) randomized controlled trials are urgently needed to determine the additional value of PIPAC in this setting. Until then, PIPAC should preferably be performed in the setting of clinical trials.
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Affiliation(s)
- Robin J Lurvink
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | | | - Koen P Rovers
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | - Ignace H J T de Hingh
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.,GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
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Castagna A, Zander AJ, Sautkin I, Schneider M, Shegokar R, Königsrainer A, Reymond MA. Enhanced intraperitoneal delivery of charged, aerosolized curcumin nanoparticles by electrostatic precipitation. Nanomedicine (Lond) 2021; 16:109-120. [PMID: 33448879 DOI: 10.2217/nnm-2020-0373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aims: To investigate the potential of curcumin-loaded polylactic-co-glycolic acid nanoparticles (CUR-PLGA-NPs), alone and with electrostatic precipitation, for improving tissue uptake during pressurized intraperitoneal aerosol chemotherapy (PIPAC). Methods: Positively and negatively charged CUR-PLGA-NPs were delivered as PIPAC into inverted bovine urinary bladders ex vivo. The experiment was repeated with the additional use of electrostatic precipitation pressurized intraperitoneal aerosol chemotherapy (electrostatic PIPAC). Results: Positively charged CUR-PLGA-NPs increased depth of tissue penetration by 81.5% and tissue concentration by 80%. Electrostatic precipitation further improved the uptake of positively charged CUR-PLGA-NPs by 41.8%. Conclusion: The combination of positive charge and electrostatic precipitation have significant potential to improve tissue uptake of nanoparticles during intraperitoneal chemotherapy.
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Affiliation(s)
- Arianna Castagna
- Department of General, Visceral & Transplant Surgery, Comprehensive Cancer Center, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Alexandra J Zander
- Department of Pharmacy, Biopharmaceutics & Pharmaceutical Technology, Saarland University, Saarbrücken 66123, Germany
| | - Iaroslaw Sautkin
- Department of General, Visceral & Transplant Surgery, Comprehensive Cancer Center, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Marc Schneider
- Department of Pharmacy, Biopharmaceutics & Pharmaceutical Technology, Saarland University, Saarbrücken 66123, Germany
| | | | - Alfred Königsrainer
- Department of General, Visceral & Transplant Surgery, Comprehensive Cancer Center, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Marc André Reymond
- Department of General, Visceral & Transplant Surgery, Comprehensive Cancer Center, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
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Taibi A, Sgarbura O, Hübner M. ASO Author Reflections: Developing Next-Generation Intraperitoneal Chemotherapy. Ann Surg Oncol 2020; 28:3861-3862. [PMID: 33216262 DOI: 10.1245/s10434-020-09377-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Abdelkader Taibi
- Digestive Surgery Department, Dupuytren Limoges University Hospital, Limoges, France. .,University Limoges, CNRS, XLIM, UMR 7252, 87000, Limoges, France.
| | - Olivia Sgarbura
- Surgical Oncology Department, Montpellier Cancer Institute (ICM), University of Montpellier, Montpellier, France
| | - Martin Hübner
- Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
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ZHANG YUE, CAO GANGSHENG, ZHAO TONGTONG, ZHANG HANYANG, ZHANG JUNTIAN, XIA CHUNMING. A PILOT STUDY OF MECHANOMYOGRAPHY-BASED HAND MOVEMENTS RECOGNITION EMPHASIZING ON THE INFLUENCE OF FABRICS BETWEEN SENSOR AND SKIN. J MECH MED BIOL 2020. [DOI: 10.1142/s0219519420500542] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Multi-channel mechanomyography (MMG) signals were acquired from the forearm when the subjects were performing eight classes of hand movements related to rehabilitation training. Ten time domain (TD) features and wavelet packet node energy (WPNE) features were extracted from each channel of MMG, and the hand movements were classified by support vector machine (SVM), extreme learning machine (ELM), linear discriminant analysis (LDA) and [Formula: see text]-nearest neighborhood (KNN) and the classifying results of three methods of collecting MMG (sensors directly on skin, sensors on cotton fabric and sensors on acrylic fiber) were compared. When all TD features were selected and SVM was adopted as the classifier, the total recognition rates of hand movements were 94.0%, 93.9% and 93.6%, respectively, of three collection methods. Using ELM can obtain similar results as SVM, with the recognition rates of 94.3%, 94.3% and 94.1%, respectively, better than using LDA (88.5%, 88.6% and 88.0%) or KNN (88.9%, 89.4% and 89.0%). For each algorithm, using TD features can acquire the highest recognition rates. Once the feature set and the classifier were selected, the total recognition rates were almost equally among three collection methods (especially for some feature sets, the differences are smaller than 1%). The results confirmed that satisfactory effects could be acquired even when the MMG was collected from sensors on fabrics with specific material, thus indicating that MMG has a unique potential value for developing wearable devices.
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Affiliation(s)
- YUE ZHANG
- Department of Mechanical Engineering, East China University of Science and Technology, No. 130, Meilong Road, Shanghai 200237, P. R. China
| | - GANGSHENG CAO
- Department of Mechanical Engineering, East China University of Science and Technology, No. 130, Meilong Road, Shanghai 200237, P. R. China
| | - TONGTONG ZHAO
- Department of Mechanical Engineering, East China University of Science and Technology, No. 130, Meilong Road, Shanghai 200237, P. R. China
| | - HANYANG ZHANG
- Department of Mechanical Engineering, East China University of Science and Technology, No. 130, Meilong Road, Shanghai 200237, P. R. China
| | - JUNTIAN ZHANG
- Department of Mechanical Engineering, East China University of Science and Technology, No. 130, Meilong Road, Shanghai 200237, P. R. China
| | - CHUNMING XIA
- Department of Mechanical Engineering, East China University of Science and Technology, No. 130, Meilong Road, Shanghai 200237, P. R. China
- School of Mechanical and Automotive Engineering, Shanghai University of Engineering Science, No. 133, Longteng Road, Shanghai 201620, P. R. China
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Intraperitoneal aerosolized drug delivery: Technology, recent developments, and future outlook. Adv Drug Deliv Rev 2020; 160:105-114. [PMID: 33132169 DOI: 10.1016/j.addr.2020.10.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/28/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022]
Abstract
Current therapies for patients with peritoneal metastases (PM) are only moderately effective. Recently, a novel locoregional treatment method for PM was introduced, consisting of a combination of laparoscopy with intraperitoneal (IP) delivery of anticancer agents as an aerosol. This 'pressurized intraperitoneal aerosol chemotherapy' (PIPAC) may enhance tissue drug penetration by the elevated IP pressure during CO2 capnoperitoneum. Also, repeated PIPAC cycles allow to accurately stage peritoneal disease and verify histological response to treatment. This review provides an overview of the rationale, indications, and currently used technology for therapeutic IP nebulization, and discusses the basic mechanisms governing aerosol particle transport and peritoneal deposition. We discuss early clinical results in patients with advanced, irresectable PM and highlight the potential of electrostatic aerosol precipitation. Finally, we discuss promising novel approaches, including nebulization of nanoparticles and prolonged release formulations.
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