Experimental Modeling and Treatment Strategies for Peritoneal Carcinomatosis

IntroductionPeritoneal carcinomatosis (PC) refers to the widespread dissemination of cancer cells in the peritoneal cavity, forming tumor nodules on the peritoneal surfaces.Since various types of cancer can spread to the peritoneum, PC is highly heterogeneous.The diversity observed in patients with cancer depends on various factors, such as differences in primary cancer treatment strategies, genetic background, age, sex, and epigenetic factors.These factors make it challenging to conduct unbiased clinical research studies. 1,2However, experimental models can help overcome these limitations and provide insights into the molecular mechanisms implicated in cancer and the efficacy of new treatment options.To enhance the accuracy of preclinical data, it is crucial to initiate a clear statement outlining the biological problem and provide a comprehensive description of the relevant model, incorporating its advantages and disadvantages. 3Preclinical experimental models consist of three methods: in vitro, in vivo, and in silico. 4While in vitro models offer some benefits, they are not fully comprehensive in accurately representing the complexity of a patient's condition.Therefore, it is crucial to consider the limitations of such models when studying diseases and developing new treatments.Ex vivo models are more complex and representative tools that are commonly used in the evaluation of intraperitoneal (IP) drug delivery and treatment efficacy.However, this type of model lacks several features, such as functional immunity and drug metabolism. 5In vivo models, such as mice, rat, and pig models, closely mimic the patient's condition and are commonly used to study diseases. 6ovel in vivo models, such as patient-derived xenograft (PDX) and transgenic mice models, are created to mimic patient tumors better. 7To represent the molecular characteristics of tumors and to choose the best treatment option for patients with cancer, individualized preclinical, experimental models need to be generated.To this end, in silico methods, known as "dry labs", analyze retrospective and prospective data in computational platforms, such as genome, transcriptome, proteome, and metabolome platforms, to provide insights into the molecular phenomena of malignancies. 8This review provides valuable insights by outlining various experimental models used in cancer research.A comprehensive understanding of these models is crucial for developing more ABSTRACTPeritoneal carcinomatosis (PC), associated with a range of gastrointestinal and gynecological malignancies, represents a significant condition characterized by the dissemination of cancer cells within the peritoneal cavity.The advancement of our comprehension of the pathophysiology and therapeutic strategies for PC hinges on utilizing experimental models.This comprehensive review provides an overview of the current experimental models employed in the examination of PC along with the current treatment strategies.The review comprehensively explores the merits and demerits of each model and their respective contributions to our understanding of peritoneal metastasis.This review will serve as a valuable resource for researchers and clinicians engaged in investigating and managing PC, offering direction for future endeavors to refine experimental modeling and clinical outcomes.