Discussion
CRC
DISEASE, PERITONEAL CARCINOMATOSIS
CRC and AC metastatic to the peritoneum is a challenging clinical entity with dismal survival of about 12–15 months with first-line chemotherapy including bevacizumab.The primary endpoints of this phase I trial were feasibility and safety of PIPAC using oxaliplatin at 90 mg/mOur findings of 50% SD by RECIST criteria are also similar to previous trials that showed SD of 62%,We noted disease responses with a PCI decrease in 42% of the patients, with another patient (8%) showing stable PCI over the course of the study. Half of the patients had a radiographic response by RECIST criteria, and additionally 58% showed histologic response by PRGS. The most accurate predictor or surrogate of survival in patients undergoing trials of locoregional therapy to the peritoneum is not known. Radiographic measurement via CT scan using RECIST criteria is the mainstay for the evaluation for PM, but CT is limited by image slice thickness (usually 3–5 mm), and meta-analyses have shown sensitivity of 68–83% and specificity of 86–88% for detecting PM on CT.The current study reports the first results in the USA from a phase I clinical trial of PIPAC in CRC and AC peritoneal carcinomatosis. Oxaliplatin at a dose of 90 mg/m