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NIPEC Treatment: Is This the Key to Long-Term Mesothelioma Survival?

ByAlex Strauss

nipec treatmentA mesothelioma treatment called NIPEC may help people with peritoneal mesothelioma live longer than expected. In some cases, much longer.

A recent study of 74 peritoneal mesothelioma patients showed a combination of cytoreductive surgery (CRS), HIPEC, and NIPEC works better than CRS/HIPEC alone.

The study comes from one of the country’s foremost medical authorities on peritoneal mesothelioma. Dr. Paul Sugarbaker runs the Peritoneal Surface Malignancy Program at Washington Cancer Institute in Washington, DC. 

Last year, Dr. Sugarbaker released results of a small study on NIPEC treatment for mesothelioma. Although that study included only six patients, the results were impressive enough to warrant further study. 

This year’s larger NIPEC study is even more promising for people fighting mesothelioma.

Similarities and DIfferences Between HIPEC and NIPEC Treatment

Peritoneal mesothelioma accounts for about a fifth of the 2,500 mesothelioma cases diagnosed in the US each year. It is a fast-growing cancer that grows on the surface of the peritoneum lining the abdomen. 

Peritoneal mesothelioma is usually fatal. But, in recent years, a combination of CRS and HIPEC has dramatically improved survival rates. HIPEC stands for heated intraperitoneal chemotherapy. It involves rinsing heated chemotherapy drugs through the abdomen immediately after surgery. The goal is to kill remaining cancer cells before they turn into new tumors. 

NIPEC stands for normothermic intraperitoneal chemotherapy. The goal is the same as HIPEC. But, in contrast to HIPEC, NIPEC treatment is delivered at room temperature. 

Another difference is that HIPEC is a one-time treatment. Tumors usually eventually come back. “A single application of a chemotherapy agent is unlikely to permanently eradicate the disease,” Dr. Sugarbaker wrote in a 2017 article. 

But NIPEC treatment takes place over time. Drugs are rinsed around the abdomen through an abdominal catheter that stays in place. People typically have six rounds of NIPEC over six months. 

NIPEC treatment is not yet as common as HIPEC. But the results of Dr. Sugarbaker’s latest study could help change that. 

Boosting Long-Term Peritoneal Mesothelioma Survival

The new NIPEC treatment study involved 74 mesothelioma patients. In this group, the most important factors in survival were 

  • Age
  • How complete their surgery was
  • What treatments they received

Then the researchers looked through the group to find 29 pairs of evenly matched patients. The only difference between them was whether they had CRS/HIPEC alone or CRS/HIPEC with NIPEC treatment added. The results were very encouraging. 

“The addition of NIPEC was associated with long-term survival in this cohort of patients,” writes Dr. Sugarbaker in the Annals of Surgical Oncology. “A multi-institutional randomized trial may be the next step.”

One of the big advantages of both HIPEC and NIPEC treatment is that they do not involve putting chemotherapy drugs into the bloodstream. Doctors can use higher doses that may be more lethal to mesothelioma cells. 

Source: 

Sugarbaker, P, and Chang, D, “Cytoreductive Surgery Plus HIPEC With and Without NIPEC for Malignant Peritoneal Mesothelioma: A Propensity-Matched Analysis”, May 3, 2021, Annals of Surgical Oncology, Online ahead of print, https://link.springer.com/article/10.1245%2Fs10434-021-10048-4

 

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