Background: The optimal choice of cytotoxic drugs for intraperitoneal chemotherapy (IPC) in conjunction with\r\ncytoreductive surgery (CRS) for treatment of peritoneal carcinomatosis (PC) is poorly defined. We investigated drug\r\nsensitivity ex vivo in patient samples of various PC tumor types and correlated clinical outcome to drug sensitivity\r\nwithin the subset of PC from colorectal cancer (CRC).\r\nMethods: PC tissue samples (n = 174) from mesothelioma, pseudomyxoma peritonei (PMP), ovarian cancer, CRC or\r\nappendix cancer were analyzed ex vivo for sensitivity to oxaliplatin, cisplatin, mitomycin C, melphalan, irinotecan,\r\ndocetaxel, doxorubicin and 5-FU. Clinicopathological variables and outcome data were collected for the CRC subset.\r\nResults: Mesothelioma and ovarian cancer were generally more drug sensitive than CRC, appendix cancer and\r\nPMP. Oxaliplatin showed the most favorable ratio between achievable IPC concentration and ex vivo drug\r\nsensitivity. Drug sensitivity in CRC varied considerably between individual samples. Ex vivo drug sensitivity did not\r\nobviously correlate to time-to-progression (TTP) in individual patients.\r\nConclusions: Drug-sensitivity varies considerably between PC diagnoses and individual patients arguing for\r\nindividualized therapy in IPC rather than standard diagnosis-specific therapy. However, in the current paradigm of\r\ntreatment according to diagnosis, oxaliplatin is seemingly the preferred drug for IPC from a drug sensitivity and\r\nconcentration perspective. In the CRC subset, analysis of correlation between ex vivo drug sensitivity and TTP was\r\ninconclusive due to the heterogeneous nature of the data.
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