Peritoneal Carcinomatosis: Pathophysiology, Prevention, and Treatment

Size: px
Start display at page:

Download "Peritoneal Carcinomatosis: Pathophysiology, Prevention, and Treatment"

Transcription

1 Peritoneal Carcinomatosis: Pathophysiology, Prevention, and Treatment Wim Ceelen, MD, PhD, FACS GI Surgery, UZ Gent KAGB 27/4/2013

2 Overview What is peritoneal carcinomatosis? Rationale for IP drug delivery and hyperthermic IP Chemoperfusion (HIPEC) Results

3 Primary Peritoneal Malignancy Malignant peritoneal mesothelioma Cystic mesothelioma Primary peritoneal carcinoma Desmoplastic round cell tumor (DRCT) Peritoneal sarcoma

4 Secundary Peritoneal Malignancy Extraabdominal tumours Lobular breast cancer Lung cancer Melanoma Intraabdominal tumours Ovarian cancer GI cancer: stomach, pancreas, colon, appendix Pseudomyxoma peritonei (PMP)

5 Steps in the peritoneal metastatic cascade 1. Liberation of cells from primary tumor 2. Transport throughout the peritoneal cavity 3. Adhesion and invasion 4. Systemic spread

6 Peritoneal shedding of tumor cells T4 or perforated tumors (colon) Iatrogenic spill Tumor tisue incision or biopsy Blood/lymph vessels section Bile duct section Elevated Interstitial Fluid Pressure (IFP)

7 Heldin Nat Rev Cancer 2004

8

9 How do cancer cells move in the peritoneal cavity? Passive Gravity Respiratory movements Peritoneal recesses Active movement Predictable flow of cells

10 Yamazaki et al. Cancer Sci 2005

11 Adhesion of tumor cells in the To mesothelial cells peritoneal cavity To underlying ECM Special locations: greater omentum; diaphragm

12 Ceelen Lancet Oncol 2009

13 Nature Med 2011

14

15 Invasion of submesothelial layers Areas of peritoneal discontinuity Specific anatomic locations Contraction of MC by inflammatory mediators (HGF) Induction of apoptosis of mesothelial cells Release of proteases, e.g. MMP-7

16 PC: Indications for extensive Tx Appendiceal neoplasm, PMP Colorectal cancer Ovarian cancer Epitheloid malignant peritoneal mesothelioma Other?

17

18 A rose by any other name... Peritonitis myxomatosa chronica (Virchow) Maladie gélatineuse du péritoine (Péan) Pseudomyxoma peritonei (Werth, 1884) Richard Werth

19 Prevalence of PC in CRC Underestimated Registry data (Sweden; Norway; The Netherlands) Isolated Synchronous PC: 5% Metachronous PC: 4-12%

20 Risk factors for PC in CRC Honoré Ann Surg Oncol 2012

21 CRS + HIPEC Cytoreductive surgery (debulking) Peritonectomy Intraoperative chemoperfusion under hyperthermic conditions

22

23 Philosoph Trans 1744

24 Postop IP Chemo in Ovarian Cancer

25 Rationale for Hyperthermic IP chemotherapy (HIPEC) IP Chemotherapy Pharmacokinetic argument: peritoneal plasma barrier higher dose feasible Maximal effect immediately after cytoreduction Limited systemic resorption / toxicity Hyperthermia Pharmacodynamic argument: increased drug penetration Selective cytotoxicity of hyperthermia Synergism with chemotherapy and radiotherapy

26 Peritoneal plasma barrier Flessner Am J Physiol Renal Physiol 288: F433-F442, 2005

27 De Lima Vaquez Cancer Chemother Pharmacol 2003

28 Ceelen Nat Rev Clin Oncol 2010

29 Ceelen Cancer Treat Rev 2007

30 Wiener klin Wochenschrift 1974

31 PMP; two procedures: Thiotepa 60 mg/m 2 and MTX 40 mg/m 2

32 Safety considerations Adequate personnel protection Adequate disposal of material and body fluids Coliseum technique: adequate vapor evacuation Adequate safety handbook/guidelines

33 Complications of HIPEC Prolonged ileus < hyperthermia Chemotherapy toxicity (bone marrow, renal, hepatic): rare Oxaliplatin: autoimmune thrombopenia; mild hepatic toxicity Cisplatin: nephrotoxicity; thiosulphate iv Increased risk of anastomotic leak Risk of the combined procedure mainly related to extent of surgery

34 Makrin J Surg Oncol 2005

35 Limitations of HIPEC Local toxicity Limited tissue penetration (3 mm) Limited contact time Only non cell cycle specific chemotherapy

36 Results: PMP Chua J Clin Oncol 2012

37 Results: CRC Elias J Clin Oncol 2009

38 Results: EOC Ceelen Ann Surg Oncol 2009

39 Ongoing Phase III Studies Colon cancer Prodige 7: CRS versus CRS+HIPEC ProphyloChip: mandatory 2nd look Ovarian cancer CHIPOR: relapsed OC, cytoreduction ± HIPEC (cisplatin 75 mg) NKI: secondary debulking surgery ± HIPEC

40 Unresolved issues Specific contribution of HIPEC (versus cytoreduction) Role of hyperthermia Standardization of hyperthermic drug delivery Role of (neo) adjuvant therapy Staging of PC; patient selection

41 Normo- versus hyperthermic chemoperfusion in PC from CRC (NCT )

42 Future Developments Data from Phase III trials awaited More efficient IP drug delivery: nanocarriers, hydrogels Multimodal strategies: postop repeated IP cycles

43

Intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Volodymyr Labinskyy MD

Intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Volodymyr Labinskyy MD Intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Volodymyr Labinskyy MD KCHC 8/29/13 52 y.o. F presented with severe pain in the right back and right flank, sharp, 8 out of 10, for 7 days.

More information

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) as Part of an Integrative Treatment Plan for Colorectal Peritoneal Carcinomatosis

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) as Part of an Integrative Treatment Plan for Colorectal Peritoneal Carcinomatosis Hyperthermic Intraperitoneal Chemotherapy (HIPEC) as Part of an Integrative Treatment Plan for Colorectal Peritoneal Carcinomatosis T. Christopher Windham, M.D., F.A.C.S. Medical Director, Florida Hospital

More information

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Now and the Future

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Now and the Future Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Now and the Future Mazin Al-kasspooles, MD Associate Professor of Surgery Division of Surgical Oncology Director, Regional Therapy

More information

Luis D. Carcorze Soto, MD PGY-3

Luis D. Carcorze Soto, MD PGY-3 Luis D. Carcorze Soto, MD PGY-3 Peritoneal Surface Malignancies Peritoneum Patient Selection Operative Technique HIPEC EPIC Primary: Primary Peritoneal Carcinoma Malignant Peritoneal Mesothelioma Metastatic:

More information

Cytoreduction and hyperthermic intraperitoneal chemotherapy for the treatment of pseudomyxoma

Cytoreduction and hyperthermic intraperitoneal chemotherapy for the treatment of pseudomyxoma Medical Policy Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for the Treatment of Pseudomyxoma Peritonei and Peritoneal Carcinomatosis of Gastrointestinal Origin, and Peritoneal Mesothelioma

More information

Chirurgia Avanzata Del Carcinoma Ovarico Nuove Strategie A Confronto Ovarian Cancer Advanced Surgery New Strategies in Comparison

Chirurgia Avanzata Del Carcinoma Ovarico Nuove Strategie A Confronto Ovarian Cancer Advanced Surgery New Strategies in Comparison Peritoneal dissection and intraperitoneal chemotherapy under hyperthermic conditions. If you select the right patients long-term survival can be achieved. Chirurgia Avanzata Del Carcinoma Ovarico Nuove

More information

Rachel E. Kirby, Jing Zhao, Terence Chua, Winston Liauw and David L. Morris *

Rachel E. Kirby, Jing Zhao, Terence Chua, Winston Liauw and David L. Morris * Send Orders for Reprints to reprints@benthamscience.net The Open Surgical Oncology Journal, 2014, 5, 1-5 1 Open Access Avoidance of Early Post-Operative Intraperitoneal Chemotherapy (EPIC) Following Peritonectomy

More information

Post-operative intrapleural chemotherapy for mesothelioma

Post-operative intrapleural chemotherapy for mesothelioma Post-operative intrapleural chemotherapy for mesothelioma Robert Kratzke, MD John Skoglund Chair for Lung Cancer Research Section of Heme-Onc-Transplant University of Minnesota Medical School Efficacy

More information

A succesfull case of HIPEC in a peritoneal mesothelioma patient

A succesfull case of HIPEC in a peritoneal mesothelioma patient A succesfull case of HIPEC in a peritoneal mesothelioma patient Firmino, NLJ¹²; Miranda, E¹³; Oliveira, DA ²; Lima, MBA ¹²; Diniz, AF ¹²; Gomes, GES ¹²; Azevedo, LW ¹²; Soares,MC¹²; Gomes, ASA³. ¹Pernambuco

More information

Management of Peritoneal Metastases (PM) from colorectal cancers: New Perspectives. Dominique ELIAS

Management of Peritoneal Metastases (PM) from colorectal cancers: New Perspectives. Dominique ELIAS Management of Peritoneal Metastases (PM) from colorectal cancers: New Perspectives Dominique ELIAS Declaration of interest BOARDS Congress and teaching 0 Merck 0 Ipsen Novartis Sanofi Trials The peritoneum

More information

H. Richard Alexander, Jr., M.D. Department of Surgery and The Greenebaum Cancer Center University of Maryland School of Medicine Baltimore, Md

H. Richard Alexander, Jr., M.D. Department of Surgery and The Greenebaum Cancer Center University of Maryland School of Medicine Baltimore, Md Major Advances in Cancer Prevention, Diagnosis and Treatment~ Why Mesothelioma Leads the Way H. Richard Alexander, Jr., M.D. Department of Surgery and The Greenebaum Cancer Center University of Maryland

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy Hyperthermic Intraperitoneal Chemotherapy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hyperthermic_intraperitoneal_chemotherapy 5/19/2005 3/2016 3/2017

More information

Peritoneal Surface Malignancies. Ira Allen Jacobs, MD, FACS Surgical Oncology San Diego, CA

Peritoneal Surface Malignancies. Ira Allen Jacobs, MD, FACS Surgical Oncology San Diego, CA Peritoneal Surface Malignancies Ira Allen Jacobs, MD, FACS Surgical Oncology San Diego, CA Cancer dissemination routes Hematogenous metastases Lymphatic metastases Implants on peritoneal surfaces Surgically

More information

Comments: Policy Accepted during 2013 Annual Review with no changes.

Comments: Policy Accepted during 2013 Annual Review with no changes. Health Plan Coverage Policy ARBenefits Approval: 01/01/2012 Effective Date: 01/01/2012 Revision Date: 09/18/2013 Title: Cytoreduction Surgery with Hyperthermic Intraperitoneal Chemotherapy Comments: Policy

More information

INTRAPERITONEAL HYPERTHERMIC CHEMOTHERAPY (IPHC) FOR PERITONEAL CARCINOMATOSIS AND MALIGNANT ASCITES. INFORMATION FOR PATIENTS AND FAMILY MEMBERS

INTRAPERITONEAL HYPERTHERMIC CHEMOTHERAPY (IPHC) FOR PERITONEAL CARCINOMATOSIS AND MALIGNANT ASCITES. INFORMATION FOR PATIENTS AND FAMILY MEMBERS INTRAPERITONEAL HYPERTHERMIC CHEMOTHERAPY (IPHC) FOR PERITONEAL CARCINOMATOSIS AND MALIGNANT ASCITES. INFORMATION FOR PATIENTS AND FAMILY MEMBERS Description of Treatment A major difficulty in treating

More information

CANCERS OF THE PERITONEUM PERITONEAL MESOTHELIOMA PREFERRED MODEL OF CARE AND CRITERIA FOR REFERENCE CENTRES

CANCERS OF THE PERITONEUM PERITONEAL MESOTHELIOMA PREFERRED MODEL OF CARE AND CRITERIA FOR REFERENCE CENTRES CANCERS OF THE PERITONEUM PERITONEAL MESOTHELIOMA PREFERRED MODEL OF CARE AND CRITERIA FOR REFERENCE CENTRES Coordinator: Alex Kartheuser (Colorectal Surgery, Cliniques universitaires St-Luc, UCL) Authors

More information

Laparoscopic Hyperthermic Intraperitoneal Chemotherapy: Indications, Aims, and Results: A Systematic Review of the Literature

Laparoscopic Hyperthermic Intraperitoneal Chemotherapy: Indications, Aims, and Results: A Systematic Review of the Literature Ann Surg Oncol DOI 10.1245/s10434-012-2360-0 ORIGINAL ARTICLE REVIEW ARTICLE Laparoscopic Hyperthermic Intra Chemotherapy: Indications, Aims, and Results: A Systematic Review of the Literature Enrico Facchiano,

More information

Population Pharmacokinetics and Pharmacodynamics of Cisplatinum During Intraperitoneal Chemohyperthermia Using a Closed Abdominal Procedure

Population Pharmacokinetics and Pharmacodynamics of Cisplatinum During Intraperitoneal Chemohyperthermia Using a Closed Abdominal Procedure Population Pharmacokinetics and Pharmacodynamics of Cisplatinum During Intraperitoneal Chemohyperthermia Using a Closed Abdominal Procedure Eddy Cotte, Brigitte Tranchand, Annie-Claude Beaujard, François-Noël

More information

National Medical Policy

National Medical Policy National Medical Policy Subject: Policy Number: Intraperitoneal Hyperthermic Chemotherapy for Abdominopelvic Cancers NMP346 Effective Date*: June 2007 Updated: November 2014 This National Medical Policy

More information

PRODYNOV. Targeted Photodynamic Therapy of Ovarian Peritoneal Carcinomatosis ONCO-THAI. Image Assisted Laser Therapy for Oncology

PRODYNOV. Targeted Photodynamic Therapy of Ovarian Peritoneal Carcinomatosis ONCO-THAI. Image Assisted Laser Therapy for Oncology PRODYNOV Targeted Photodynamic Therapy of Ovarian Peritoneal Carcinomatosis ONCO-THAI Image Assisted Laser Therapy for Oncology Inserm ONCO-THAI «Image Assisted Laser Therapy for Oncology» Inserm ONCO-THAI

More information

INTRAOPERATIVE HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY (HIPEC)

INTRAOPERATIVE HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY (HIPEC) MEDICAL POLICY INTRAOPERATIVE HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY (HIPEC) Policy Number: CS141.A Effective Date: September 1, 2015 Table of Contents COVERAGE RATIONALE DEFINITIONS... APPLICABLE CODES..

More information

Pseudomyxoma Peritonei Where are we in 2014?

Pseudomyxoma Peritonei Where are we in 2014? Pseudomyxoma Peritonei Where are we in 2014? Santiago González-Moreno, MD, PhD Head, Department of GI Surgical Oncology Peritoneal Surface Oncology Program Medical Director * * * * * * * * * * * * French

More information

2nd International Symposium on Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC)

2nd International Symposium on Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) 2nd International Symposium on Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) Wednesday Oct 7th, 2015 Congress Center (Hörsaal 1 3) Marien Hospital Herne Accreditation by the Medical Chamber

More information

L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer

L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer Pleurectomy/decortication, hyperthermic pleural lavage with povidone-iodine and systemic chemotherapy in malignant pleural mesothelioma. A 10-year experience. L Lang-Lazdunski, A Bille, S Marshall, R Lal,

More information

Cytoreductive surgery and perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis in the elderly

Cytoreductive surgery and perioperative intraperitoneal chemotherapy for peritoneal carcinomatosis in the elderly Huang et al. World Journal of Surgical Oncology (2015) 13:262 DOI 10.1186/s12957-015-0682-7 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH Cytoreductive surgery and perioperative intraperitoneal chemotherapy

More information

Principal Investigator: Valerie W. Rusch, MD, FACS, Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center

Principal Investigator: Valerie W. Rusch, MD, FACS, Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center Protocol 1101-1088 Phase I study of intra-pleural administration of GL-ONC1 in patients with malignant pleural effusion: primary, metastases and mesothelioma Principal Investigator: Valerie W. Rusch, MD,

More information

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY Original Issue Date (Created): July 1, 2002 Most Recent Review Date (Revised): July 22, 2014 Effective Date: October 1, 2014 POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT

More information

Brigham and Women s Hospital, Boston, MA, USA; 2 Verastem, Inc., Boston, MA, USA

Brigham and Women s Hospital, Boston, MA, USA; 2 Verastem, Inc., Boston, MA, USA Determination of Biomarker Response in a Phase II Window of Opportunity Study of Defactinib (VS 6063), a Focal Adhesion Kinase (FAK) Inhibitor, in Patients with Resectable Malignant Pleural Mesothelioma

More information

MALIGNANT MESOTHELIOMA: A TYPICAL PRESENTATION IN AN ATYPICAL PATIENT

MALIGNANT MESOTHELIOMA: A TYPICAL PRESENTATION IN AN ATYPICAL PATIENT MALIGNANT MESOTHELIOMA: A TYPICAL PRESENTATION IN AN ATYPICAL PATIENT Written by: Karyn Varley MS, SCT(ASCP) The donating laboratory would like to remain anonymous. PATIENT HISTORY 28 year old female Lived

More information

Oncologist. The. Clinical Pharmacology. Update on Chemotherapeutic Agents Utilized for Perioperative Intraperitoneal Chemotherapy

Oncologist. The. Clinical Pharmacology. Update on Chemotherapeutic Agents Utilized for Perioperative Intraperitoneal Chemotherapy The Oncologist Clinical Pharmacology Update on Chemotherapeutic Agents Utilized for Perioperative Intraperitoneal Chemotherapy PAUL H. SUGARBAKER, a JORGE TORRES MORA, b PABLO CARMIGNANI, a O. ANTHONY

More information

Cytoreduction and Intraperitoneal Chemotherapy for the Management of Non-Gynecological Peritoneal Surface

Cytoreduction and Intraperitoneal Chemotherapy for the Management of Non-Gynecological Peritoneal Surface J. Exp. Clin. Cancer Res., 22, 4, 2003 - Supplement Cytoreduction and Intraperitoneal Chemotherapy for the Management of Non-Gynecological Peritoneal Surface Malignancy Yan T.D., Esquivel J., Carmignani

More information

Peritoneal tumour service. Information for patients

Peritoneal tumour service. Information for patients Peritoneal tumour service Hyperthermic intraperitoneal chemotherapy (HIPEC) Information for patients Chemotherapy given into the abdomen during surgery is called intraoperative chemotherapy. This information

More information

Clinical Commissioning Policy: Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Mesothelioma

Clinical Commissioning Policy: Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Mesothelioma Clinical Commissioning Policy: Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Mesothelioma Reference: NHS England B03/P/a 1 Information Reader Box (IRB) to be inserted

More information

Peritoneal Carcinosis

Peritoneal Carcinosis Peritoneal Carcinosis What is it and how to cure it Peritoneum Peritoneum is a thin and transparent membrane that covers the internal part of the abdominal and pelvic cavity and all the viscera contained

More information

MesoPDT. Photodynamic Therapy for malignant pleural mesothelioma ONCO-THAI. Image Assisted Laser Therapy for Oncology

MesoPDT. Photodynamic Therapy for malignant pleural mesothelioma ONCO-THAI. Image Assisted Laser Therapy for Oncology MesoPDT Photodynamic Therapy for malignant pleural mesothelioma ONCO-THAI Image Assisted Laser Therapy for Oncology Unité Inserm ONCO-THAI «Image Assisted Laser Therapy for Oncology» Inserm ONCO-THAI "Image

More information

Clinical Commissioning Policy: Cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Mesothelioma

Clinical Commissioning Policy: Cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Mesothelioma Clinical Commissioning Policy: Cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Mesothelioma Reference: NHS England A08/P/c 2 NHS England INFORMATION READER BOX Directorate

More information

Cigna Medical Coverage Policy

Cigna Medical Coverage Policy Cigna Medical Coverage Policy Subject Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Table of Contents Coverage Policy... 1 General Background... 1 Coding/Billing Information... 8 References... 8 Effective

More information

INTRODUCTION. Abstract Background. 3 Centre hospitalier Lyon Sud Hospices Civils de Lyon, Pierre-Bé

INTRODUCTION. Abstract Background. 3 Centre hospitalier Lyon Sud Hospices Civils de Lyon, Pierre-Bé Childbearing after hyperthermic intraperitoneal chemotherapy: results from an international survey Pablo Ortega-Deballon 1 2 *, Olivier Glehen 3, Edward Levine 4, Pompiliu Piso, Paul H. Sugarbaker 6, Andrea

More information

Evidence-Based Medicine in the Treatment of Peritoneal Carcinomatosis: Past, Present, and Future

Evidence-Based Medicine in the Treatment of Peritoneal Carcinomatosis: Past, Present, and Future 2009;100:335 344 Evidence-Based Medicine in the Treatment of Peritoneal Carcinomatosis: Past, Present, and Future AVIRAM NISSAN, MD, 1,2 * ALEXANDER STOJADINOVIC, MD, 3,4 ALFREDO GAROFALO, MD, 5{ JESUS

More information

Effusions: Mesothelioma and Metastatic Cancers

Effusions: Mesothelioma and Metastatic Cancers Effusions: Mesothelioma and Metastatic Cancers Malignant Mesothelioma Incidence: 2,500 cases/year ~60-80% pts with pleural MM relationship with asbestos exposure Other risk factors: radiation, other carcinogens,

More information

IN MANY PATIENTS WITH ABDOMINAL OR PELVIC MALIGNANCIES, surgical treatment

IN MANY PATIENTS WITH ABDOMINAL OR PELVIC MALIGNANCIES, surgical treatment Sugarbaker, Cancerología 3 (2008): 119-124 1 Washington Cancer Institute, Washington, DC, USA Overview of Peritoneal Carcinomatosis Paul H. Sugarbaker 1 Abstract IN MANY PATIENTS WITH ABDOMINAL OR PELVIC

More information

Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma. Claire Vines, 2016 Pharm.D. Candidate

Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma. Claire Vines, 2016 Pharm.D. Candidate + Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma Claire Vines, 2016 Pharm.D. Candidate + Disclosure I have no conflicts of interest to disclose. + Objectives Summarize NCCN

More information

Mesothelioma. Malignant Pleural Mesothelioma

Mesothelioma. Malignant Pleural Mesothelioma Mesothelioma William G. Richards, PhD Brigham and Women s Hospital Malignant Pleural Mesothelioma 2,000-3,000 cases per year (USA) Increasing incidence Asbestos (50-80%, decreasing) 30-40 year latency

More information

MEDICAL POLICY SUBJECT: HYPERTHERMIA AS A CANCER TREATMENT. POLICY NUMBER: 2.01.25 CATEGORY: Technology Assessment

MEDICAL POLICY SUBJECT: HYPERTHERMIA AS A CANCER TREATMENT. POLICY NUMBER: 2.01.25 CATEGORY: Technology Assessment MEDICAL POLICY SUBJECT: HYPERTHERMIA AS A CANCER PAGE: 1 OF: 7 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product, including

More information

Frequently Asked Questions About Ovarian Cancer

Frequently Asked Questions About Ovarian Cancer Media Contact: Gerri Gomez Howard Cell: 303-748-3933 gerri@gomezhowardgroup.com Frequently Asked Questions About Ovarian Cancer What is ovarian cancer? Ovarian cancer is a cancer that forms in tissues

More information

Overview of Ovarian Cancer. Dr. Sinead Noonan 13/03/2012

Overview of Ovarian Cancer. Dr. Sinead Noonan 13/03/2012 Overview of Ovarian Cancer Dr. Sinead Noonan 13/03/2012 Ovarian Cancer 4 th most common cause of cancer death in women 15,000 deaths/year in the US Each year 300 new cases in Ireland 80% epithelial cell

More information

New strategies in anticancer therapy

New strategies in anticancer therapy 癌 症 診 療 指 引 簡 介 及 臨 床 應 用 New strategies in anticancer therapy 中 山 醫 學 大 學 附 設 醫 院 腫 瘤 內 科 蔡 明 宏 醫 師 2014/3/29 Anti-Cancer Therapy Surgical Treatment Radiotherapy Chemotherapy Target Therapy Supportive

More information

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY MALIGNANT MESOTHELIOMA CLASSIFICATION MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY Sisko Anttila, MD, PhD Jorvi Hospital Laboratory of Pathology Helsinki University Hospital Espoo,

More information

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY Sisko Anttila, MD, PhD Jorvi Hospital Laboratory of Pathology Helsinki University Hospital Espoo, Finland 2nd Nordic Conference on Applied

More information

Cytology : first alert of mesothelioma? Professor B. Weynand, UCL Yvoir, Belgium

Cytology : first alert of mesothelioma? Professor B. Weynand, UCL Yvoir, Belgium Cytology : first alert of mesothelioma? Professor B. Weynand, UCL Yvoir, Belgium Introduction 3 cavities with the same embryologic origin the mesoderme Pleura Exudates Pleura Peritoneum Pericardium 22%

More information

MEDICAL POLICY POLICY TITLE

MEDICAL POLICY POLICY TITLE Original Issue Date (Created): July 1, 2002 Most Recent Review Date (Revised): Effective Date: April 15, 2008 July 1, 2009- RETIRED I. DESCRIPTION/BACKGROUND High dose chemotherapy (HDC) involves the administration

More information

INDIAN JOURNAL OF MEDICAL & PAEDIATRIC ONCOLOGY Vol. 28 No 1, 2007 1 4

INDIAN JOURNAL OF MEDICAL & PAEDIATRIC ONCOLOGY Vol. 28 No 1, 2007 1 4 INDIAN JOURNAL OF MEDICAL & PAEDIATRIC ONCOLOGY Vol. 28 No 1, 2007 1 4 Original Article-II Primary Versus Interval Cytoreductive Surgery in Treatment of Advanced Ovarian Cancer ABDUL RASHID LONE, MUSHTAQ

More information

Report series: General cancer information

Report series: General cancer information Fighting cancer with information Report series: General cancer information Eastern Cancer Registration and Information Centre ECRIC report series: General cancer information Cancer is a general term for

More information

Ovarian Cancer. Josie Rutovitz

Ovarian Cancer. Josie Rutovitz Ovarian Cancer Josie Rutovitz Extent of the Problem In 2006 = 9 th most common cancer in women (Aust Institute of Health and Welfare). 1226 new cases in 2006. 60% of cases are post menopausal. 47% increase

More information

CHAPTER 2. Neoplasms (C00-D49) March 2014. 2014 MVP Health Care, Inc.

CHAPTER 2. Neoplasms (C00-D49) March 2014. 2014 MVP Health Care, Inc. Neoplasms (C00-D49) March 2014 2014 MVP Health Care, Inc. CHAPTER SPECIFIC CATEGORY CODE BLOCKS C00-C14 Malignant neoplasms of lip, oral cavity and pharynx C15-C26 Malignant neoplasms of digestive organs

More information

COMMISSIONING. for ULTRA-RADICAL SURGERY ADVANCED OVARIAN CANCER

COMMISSIONING. for ULTRA-RADICAL SURGERY ADVANCED OVARIAN CANCER COMMISSIONING for ULTRA-RADICAL SURGERY in ADVANCED OVARIAN CANCER WHY THIS MUST HAPPEN PERSPECTIVE COMMISSIONING FOR WHO, FOR WHAT? Biological Basis Surgical Basis International and national standards

More information

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background Imaging of Pleural Tumors Mylene T. Truong, MD Imaging of Pleural Tumours Mylene T. Truong, M. D. University of Texas M.D. Anderson Cancer Center, Houston, TX Objectives To review tumors involving the

More information

Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs. Case Study. Surgery. Lumpectomy and Radiation

Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs. Case Study. Surgery. Lumpectomy and Radiation Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs Michael Alvarado, MD Associate Professor of Surgery University of California San Francisco Case Study 59 yo woman with new palpable

More information

Grade 4 Thrombocytopenia During. Predictor of Response in Melanoma but Not in Renal Cell Cancer.

Grade 4 Thrombocytopenia During. Predictor of Response in Melanoma but Not in Renal Cell Cancer. Grade 4 Thrombocytopenia During Treatment with High-Dose IL-2 2 (HD IL-2) is a Predictor of Response in Melanoma but Not in Renal Cell Cancer. Timothy E. Bael, M.D. Bercedis L. Peterson, Ph.D. Karima Rasheed,

More information

The effect of the introduction of ICD-10 on cancer mortality trends in England and Wales

The effect of the introduction of ICD-10 on cancer mortality trends in England and Wales The effect of the introduction of ICD-10 on cancer mortality trends in Anita Brock, Clare Griffiths and Cleo Rooney, Offi ce for INTRODUCTION From January 2001 deaths in have been coded to the Tenth Revision

More information

Epithelial Ovarian Cancer

Epithelial Ovarian Cancer Epithelial Ovarian Cancer Fred Ueland, MD University of Kentucky Gynecologic Oncology Epithelial Ovarian Cancer Radiotherapy Ovarian Cancer Radiotherapy Ovarian cancer is usually radiosensitive Whole abdominal

More information

Oncos Therapeutics: ONCOS THERAPEUTICS Personalized Cancer Immunotherapy. March 2015. Antti Vuolanto, COO and co-founder

Oncos Therapeutics: ONCOS THERAPEUTICS Personalized Cancer Immunotherapy. March 2015. Antti Vuolanto, COO and co-founder Oncos Therapeutics: Personalized Cancer Immunotherapy ONCOS THERAPEUTICS Personalized Cancer Immunotherapy March 2015 Antti Vuolanto, COO and co-founder 1 History of Oncos Therapeutics 2002 2007 2009 Research

More information

Summary of treatment benefits

Summary of treatment benefits Risk Management Plan PEMETREXED Powder for concentrate for Solution for infusion Pemetrexed is also indicated as monotherapy for the maintenance treatment of locally advanced or metastatic non small cell

More information

Multiple Primary and Histology Site Specific Coding Rules KIDNEY. FLORIDA CANCER DATA SYSTEM MPH Kidney Site Specific Coding Rules

Multiple Primary and Histology Site Specific Coding Rules KIDNEY. FLORIDA CANCER DATA SYSTEM MPH Kidney Site Specific Coding Rules Multiple Primary and Histology Site Specific Coding Rules KIDNEY 1 Prerequisites 2 Completion of Multiple Primary and Histology General Coding Rules 3 There are many ways to view the Multiple l Primary/Histology

More information

Multidisciplinary discussion of: Early staged NSCLC

Multidisciplinary discussion of: Early staged NSCLC Multidisciplinary discussion of: Early staged NSCLC 2 different classes of patients Stage IIIA pt2pn2 Stage IIB pt3pn0 2 different classes of patients 50% 40% 30% 20% 10% 3y survival 50% 40% 30% 20% 10%

More information

Avastin: Glossary of key terms

Avastin: Glossary of key terms Avastin: Glossary of key terms Adenocarcinoma Adenoma Adjuvant therapy Angiogenesis Anti-angiogenics Antibody Antigen Avastin (bevacizumab) Benign A form of carcinoma that originates in glandular tissue.

More information

Protocol. Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy for Select Intra-Abdominal and Pelvic Malignancies

Protocol. Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy for Select Intra-Abdominal and Pelvic Malignancies Chemotherapy for Select Intra-Abdominal and Pelvic Malignancies (20307) (Formerly Chemotherapy for the Treatment of Pseudomyxoma Peritonei, Peritoneal Carcinomatosis of Gastrointestinal Origin, and Peritoneal

More information

PRIMARY SEROUS CARCINOMA OF PERITONEUM: A CASE REPORT

PRIMARY SEROUS CARCINOMA OF PERITONEUM: A CASE REPORT PRIMARY SEROUS CARCINOMA OF PERITONEUM: A CASE REPORT Dott. Francesco Pontieri (*) U.O. di Anatomia Patologica P.O. di Rossano (CS) Dott. Gian Franco Zannoni Anatomia Patologica Facoltà di Medicina e Chirurgia

More information

Lung Cancer: More than meets the eye

Lung Cancer: More than meets the eye Lung Cancer Education Program November 23, 2013 Lung Cancer: More than meets the eye Shantanu Banerji MD, FRCPC Presenter Disclosure Faculty: Shantanu Banerji Relationships with commercial interests: Grants/Research

More information

NEOPLASMS C00 D49. Presented by Jan Halloran CCS

NEOPLASMS C00 D49. Presented by Jan Halloran CCS NEOPLASMS C00 D49 Presented by Jan Halloran CCS 1 INTRODUCTION A neoplasm is a new or abnormal growth. In the ICD-10-CM classification system, neoplastic disease is classified in categories C00 through

More information

Clinical Policy Bulletin: Hyperthermia in Cancer Therapy

Clinical Policy Bulletin: Hyperthermia in Cancer Therapy Hyperthermia in Cancer Therapy Page 1 of 28 Aetna Better Health 2000 Market Street, Suite 850 Philadelphia, PA 19103 AETNA BETTER HEALTH Clinical Policy Bulletin: Hyperthermia in Cancer Therapy Number:

More information

Biochemistry of Cancer Cell

Biochemistry of Cancer Cell Biochemistry of Cancer Cell Prof. Taha Kumosani Prof. Taha Kumosani http://biochemistry4all.com/taha/5.htm Cancer: an Overview Paleopathologists Dinosaur bones Egyptians Papyrus Autopsis Hippocrates Carcinoma

More information

Diseases. Inflammations Non-inflammatory pleural effusions Pneumothorax Tumours

Diseases. Inflammations Non-inflammatory pleural effusions Pneumothorax Tumours Pleura Visceral pleura covers lungs and extends into fissures Parietal pleura limits mediastinum and covers dome of diaphragm and inner aspect of chest wall. Two layers between them (pleural cavity) contains

More information

Corso Integrato di Clinica Medica ONCOLOGIA MEDICA AA 2010-2011 LUNG CANCER. VIII. THERAPY. V. SMALL CELL LUNG CANCER Prof.

Corso Integrato di Clinica Medica ONCOLOGIA MEDICA AA 2010-2011 LUNG CANCER. VIII. THERAPY. V. SMALL CELL LUNG CANCER Prof. Corso Integrato di Clinica Medica ONCOLOGIA MEDICA AA 2010-2011 LUNG CANCER. VIII. THERAPY. V. SMALL CELL LUNG CANCER Prof. Alberto Riccardi SMALL CELL LUNG CARCINOMA Summary of treatment approach * limited

More information

Ching-Yao Yang, Yu-Wen Tien

Ching-Yao Yang, Yu-Wen Tien Ching-Yao Yang, Yu-Wen Tien Division of General Surgery, Department of Surgery, National Taiwan University Hospital Oct-30-2010 Pancreatic NET have poorer prognosis when presence of liver metastases at

More information

Perioperative Intraperitoneal Chemotherapy. Annals of surgical oncology 17.9 (2010): 2370 7. Web. 17 Jan. 2015.

Perioperative Intraperitoneal Chemotherapy. Annals of surgical oncology 17.9 (2010): 2370 7. Web. 17 Jan. 2015. Alexander, H Richard et al. Treatment Factors Associated with Long-Term Survival after Cytoreductive Surgery and Regional Chemotherapy for Patients with Malignant Peritoneal Mesothelioma. Surgery 153.6

More information

Columbia University Mesothelioma Applied Research Foundation - 2009 - www.curemeso.org. Mesothelioma Center www.mesocenter.org

Columbia University Mesothelioma Applied Research Foundation - 2009 - www.curemeso.org. Mesothelioma Center www.mesocenter.org Columbia University Mesothelioma Center www.mesocenter.org Multimodal clinical trials, treatment (surgery, radiation, chemotherapy) Peritoneal mesothelioma program Immunotherapy translational, experimental

More information

Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Mesothelioma

Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Mesothelioma Original Article 291 Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Mesothelioma Grace HC Tan, 1 MBBS (London), MRCS (Edinburgh), Michelle Cheung, 1 MBBCh

More information

Advances in Treatment of Malignant Pleural Mesothelioma: A Reason for Hope

Advances in Treatment of Malignant Pleural Mesothelioma: A Reason for Hope Advances in Treatment of Malignant Pleural Mesothelioma: A Reason for Hope Daniel H. Sterman, M.D. Associate Professor of Medicine and Surgery Co-Director, PENN Mesothelioma and Pleural Program University

More information

Hospital: IRB #: Principal Phone Fax Email Investigator: Dr. A. Co-investigators: Dr. C Dr. D Dr. E Dr. F

Hospital: IRB #: Principal Phone Fax Email Investigator: Dr. A. Co-investigators: Dr. C Dr. D Dr. E Dr. F Title: Protocol for the Implementation of Treatment of Patients with Peritoneal Surface Malignancy with Hyperthermic Intraoperative Intraperitoneal Chemotherapy and Normothermic Early Postoperative Intraperitoneal

More information

David Feltl, M.D., Ph.D., MBA. Structure and organization of cancer care in the Czech Republic. Assessment of outputs and outcomes.

David Feltl, M.D., Ph.D., MBA. Structure and organization of cancer care in the Czech Republic. Assessment of outputs and outcomes. David Feltl, M.D., Ph.D., MBA Structure and organization of cancer care in the Czech Republic. Assessment of outputs and outcomes. Contents Cancer epidemiology in the Czech Republic National oncology program

More information

PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY. Dr. Shailesh V. Shrikhande

PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY. Dr. Shailesh V. Shrikhande PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY Dr. Shailesh V. Shrikhande Associate Professor & Consultant Surgeon GI and HPB Surgical Oncology Tata Memorial Hospital, Mumbai INDIA HELICAL

More information

Liver Cancer And Tumours

Liver Cancer And Tumours Liver Cancer And Tumours What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood from all parts of the body, cancer cells from elsewhere can

More information

O. Glehen 1,2, E. Cotte 1,2, J. C. Lifante 1,2, C. Arvieux 2,3, N. Moles 1, C. Brigand 2,4, A. C. Beaujard 1,2, Y. François 1,2, F. N.

O. Glehen 1,2, E. Cotte 1,2, J. C. Lifante 1,2, C. Arvieux 2,3, N. Moles 1, C. Brigand 2,4, A. C. Beaujard 1,2, Y. François 1,2, F. N. Acta chir belg, 2006, 106, 285-290 Peritoneal Carcinomatosis in Digestive Cancers : Cytoreductive Surgery Combined with Intraperitoneal Chemohyperthermia. The Experience in Centre Hospitalier et Universitaire

More information

Yue Zhu, Nader Hanna, Cherif Boutros, H. Richard Alexander Jr. Background

Yue Zhu, Nader Hanna, Cherif Boutros, H. Richard Alexander Jr. Background Review Article Assessment of clinical benefit and quality of life in patients undergoing cytoreduction and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for management of peritoneal metastases Yue

More information

Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda

Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda Stomach (Gastric) Cancer Prof. M K Mahajan ACDT & RC Bathinda Gastric Cancer Role of Radiation Layers of the Stomach Mucosa Submucosa Muscularis Serosa Stomach and Regional Lymph Nodes Stomach and Regional

More information

Malignant Mesothelioma

Malignant Mesothelioma Malignant Malignant mesothelioma is a tumour originating from mesothelial cells. 85 95% of mesotheliomas are caused by asbestos exposure. It occurs much more commonly in the chest (malignant pleural mesothelioma)

More information

Malignant Mesothelioma

Malignant Mesothelioma Malignant mesothelioma is a tumour originating from mesothelial cells. 85 95% of mesotheliomas are caused by asbestos exposure. It occurs much more commonly in the chest (malignant pleural mesothelioma)

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: microwave_tumor_ablation 12/2011 11/2015 11/2016 11/2015 Description of Procedure or Service Microwave ablation

More information

Malignant Mesothelioma State of the Art

Malignant Mesothelioma State of the Art Malignant Mesothelioma State of the Art Paul Baas The Netherlands Cancer Institute August 12, 2011, Carlsbad, CA Summary Diagnosis; epithelial type subdivided Pleiomorphic vs other Staging: IASLC-IMIG

More information

SMALL CELL LUNG CANCER

SMALL CELL LUNG CANCER Protocol for Planning and Treatment The process to be followed in the management of: SMALL CELL LUNG CANCER Patient information given at each stage following agreed information pathway 1. DIAGNOSIS New

More information

Mesothelioma. 1995-2013, The Patient Education Institute, Inc. www.x-plain.com ocft0101 Last reviewed: 03/21/2013 1

Mesothelioma. 1995-2013, The Patient Education Institute, Inc. www.x-plain.com ocft0101 Last reviewed: 03/21/2013 1 Mesothelioma Introduction Mesothelioma is a type of cancer. It starts in the tissue that lines your lungs, stomach, heart, and other organs. This tissue is called mesothelium. Most people who get this

More information

Clinical Commissioning Policy: Cytoreduction surgery for patients with peritoneal carcinomatosis April 2013. Reference : NHSCB/A08/P/a

Clinical Commissioning Policy: Cytoreduction surgery for patients with peritoneal carcinomatosis April 2013. Reference : NHSCB/A08/P/a Clinical Commissioning Policy: Cytoreduction surgery for patients with peritoneal carcinomatosis April 2013 Reference : NHS Commissioning Board Clinical Commissioning Policy for Cytoreduction surgery for

More information

Gemcitabine, Paclitaxel, and Trastuzumab in Metastatic Breast Cancer

Gemcitabine, Paclitaxel, and Trastuzumab in Metastatic Breast Cancer Gemcitabine, Paclitaxel, and Trastuzumab in Metastatic Breast Cancer Review Article [1] December 01, 2003 By George W. Sledge, Jr, MD [2] Gemcitabine (Gemzar) and paclitaxel show good activity as single

More information

HER2 Status: What is the Difference Between Breast and Gastric Cancer?

HER2 Status: What is the Difference Between Breast and Gastric Cancer? Ask the Experts HER2 Status: What is the Difference Between Breast and Gastric Cancer? Bharat Jasani MBChB, PhD, FRCPath Marco Novelli MBChB, PhD, FRCPath Josef Rüschoff, MD Robert Y. Osamura, MD, FIAC

More information

Cancer Treatments Subcommittee of PTAC Meeting held 2 March 2012. (minutes for web publishing)

Cancer Treatments Subcommittee of PTAC Meeting held 2 March 2012. (minutes for web publishing) Cancer Treatments Subcommittee of PTAC Meeting held 2 March 2012 (minutes for web publishing) Cancer Treatments Subcommittee minutes are published in accordance with the Terms of Reference for the Pharmacology

More information

Cancer treatment. TOP EUROPEAN CANCER EXPERTISE The path to recovery

Cancer treatment. TOP EUROPEAN CANCER EXPERTISE The path to recovery Cancer treatment TOP EUROPEAN CANCER EXPERTISE The path to recovery 0% LAND OF HIGH QUALITY HEALTHCARE Located in Finland, a land of high quality healthcare, Helsinki University Hospital is regarded as

More information

Multi-institutional experience of diffuse intra-abdominal multicystic peritoneal mesothelioma

Multi-institutional experience of diffuse intra-abdominal multicystic peritoneal mesothelioma Original article Multi-institutional experience of diffuse intra-abdominal multicystic peritoneal mesothelioma T. C. Chua 1,T.D.Yan 1,2, M. Deraco 3,O.Glehen 4,B.J.Moran 5 and P. H. Sugarbaker 6,onbehalf

More information

Cancer of the Cardia/GE Junction: Surgical Options

Cancer of the Cardia/GE Junction: Surgical Options Cancer of the Cardia/GE Junction: Surgical Options Michael A Smith, MD Associate Chief Thoracic Surgery Center for Thoracic Disease St Joseph s Hospital and Medical Center Phoenix, AZ Michael Smith, MD

More information

PROTOCOL OF THE RITA DATA QUALITY STUDY

PROTOCOL OF THE RITA DATA QUALITY STUDY PROTOCOL OF THE RITA DATA QUALITY STUDY INTRODUCTION The RITA project is aimed at estimating the burden of rare malignant tumours in Italy using the population based cancer registries (CRs) data. One of

More information