PICCOS TRIAL

Tender description

Bowel, ovarian and stomach cancer often spreads to the lining of the abdominal cavity. This trial aims to determine if a new way of delivering chemotherapy as a spray, directly into the peritoneal cavity, might improve survival in patients with peritoneal metastases, compared to conventional intravenous chemotherapy. Critically, we will also assess the impact of treatment on patient quality of life. Up to 13%, 50% and 14% of patients with bowel, ovarian and stomach cancer respectively, present with peritoneal metastases. When this form of spread occurs, patients are normally told their disease is incurable. As well as a relatively rapid decline, peritoneal metastases can cause a series of unpleasant symptoms due to new tumour growth. Peritoneal metastases are difficult to treat with conventional anticancer drugs and there is an urgent need to develop new treatment strategies. A new strategy showing potential is Pressurised IntraPeritoneal Aerosol Chemotherapy (PIPAC). PIPAC delivers anti-cancer drugs into the peritoneal cavity as an aerosol during keyhole surgery. PIPAC has been shown to deliver higher doses of chemotherapy directly to tumour sites compared to conventional treatment, with fewer side-effects due to less chemotherapy circulating in the blood. PIPAC has been shown to be both safe and feasible in a series of clinical trials. The question that now remains is whether PIPAC is efficacious or not. PIPAC has excited much interest in patient groups. CAV will disseminate study results through social media, relevant charitable organisations, presentation at academic conferences, peer-reviewed journals as well as through the trial web page hosted at the Centre for Trials Research. Information leaflets, public presentations and media coverage are integral elements of our public engagement plans. The results will strongly influence a future NICE review of PIPAC in the UK.