ASO Author Reflections: Defining the Role of PIPAC in Ovarian Cancer – Results from a U.S. Phase 1 Clinical Trial

PASTOvarian cancer (OC) often presents with peritoneal metastases (PM), which contribute significantly to morbidity and treatment resistance.Intraperitoneal (IP) chemotherapy combined with optimal cytoreductive surgery improves survival outcomes, both as normothermic and hyperthermic treatment.While hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with overall survival benefit in patients with OC, applicability is largely limited to the firstline setting, highlighting the need for localized therapies in the recurrent patient population.Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged as a promising modality for locoregional drug delivery in peritoneal surface malignancies, including in OC.Several single-arm phase II trials in Europe have demonstrated encouraging responses in patients with OC. 1,2 These trials, however, enrolled patients with OC with disease limited to the peritoneal cavity, thus omitting a large portion of recurrent patients with OC affected by extraperitoneal and distant metastases.Evaluating efficacy in previous PIPAC trials in OC has also been