IntraPeritoneal Carcinoma
Under-recognized disease
Peritoneal cancer is difficult to diagnose, especially because it can’t be detected with standard radiological imaging. As a result, the incidence of peritoneal cancer has long been underestimated and considered rare. This may be true for specific types of primary peritoneal cancer, such as malignant mesothelioma and pseudomyxoma peritonei (PMP). Today, the reported incidence rates of peritoneal cancer vary but increasing awareness has led to increased reported incidence. In contrast to mesothelioma and PMP, peritoneal cancer arising from a malignant tumor elsewhere is in the body (colon cancer, gastric cancer and ovarian cancer) is much more common and affects hundreds of thousands of patients each year.
Significant unmet medical needs
The standard of care for peritoneal cancer has remained largely unchanged since the 1970s. Intravenous chemotherapy is used after surgery (adjuvant) to treat any residual disease, or before surgery (neoadjuvant) when a tumor cannot be completely removed or optimally debulked via surgery.
Chemotherapy can be given intravenously or in the peritoneal cavity. Intraperitoneal delivery enhances drug delivery at peritoneal surface and improves overall survival from 49.7 to 65.6 months by eliminating microscopic peritoneal disease more efficiently and delivering a much higher dose of the active drug (Internal clinical oncology 19: 1001–1007, 2001). Efficacy of the relevant chemotherapy can be increased by heating the solution and administering the procedure under anesthesia via Hyperthermic Intraperitoneal Enhanced Chemotherapy (HIPEC).
Current chemotherapies used have not been optimized nor approved for intraperitoneal use. Common therapies can include Paclitaxel, Cisplatin, Topotecan, Doxorubicin, Epirubicin, and Gemcitabine.
Though existing intraperitoneal chemotherapy is associated with longer progression-free survival and overall survival, it is invasive, it causes more adverse side effects and toxicity than intravenous chemotherapy and practitioners have limited technical expertise with HIPEC. Further obstacles include two hours of additional time in the operating room, longer duration of hospitalization and increased use of diverting colostomies or ileostomies that increase the overall cost of treatment and reduce the overall quality of life.
LiPax-IP
LIPAC is developing a new Liposomal Enhanced Intraperitoneal Chemotherapy (LEIPC) for the treatment of intraperitoneal cancer, utilizing LiPax technology to improve penetration and enhance tolerability. Preclinical studies with LiPax-IP will commence side by side with ovarian cancer program.