NIPS: New chemotherapy approach for peritoneal metastases

Peritoneal metastases are among the most serious complications of advanced stomach cancer. These metastases develop when tumor cells spread to the peritoneum, a delicate layer of connective tissue that lines the abdominal cavity. To address this, experts at Hannover Medical School (MHH) have established a new treatment method known as NIPS – neoadjuvant intraperitoneal systemic therapy.

This combined therapy delivers chemotherapy both through a vein and via an implanted port system directly into the abdominal cavity, enabling cancer drugs to act more precisely on metastases.

Stomach cancer is one of the ten most common cancers, with around 14,500 new cases per year in Germany. More than a third of patients develop peritoneal metastases. “Unlike metastases in other organs, such as the liver or lungs, there are currently no effective treatment options for metastases in the peritoneum,” explains PD Thomas Wirth from the MHH Department of Gastroenterology, Hepatology, Infectiology, and Endocrinology.

Until now, two main procedures have been used:

• Cytoreduction and HIPEC (Hyperthermic Intraperitoneal Chemotherapy)
• PIPAC (Pressurized Intraperitoneal Aerosolized Chemotherapy)

Both require hospitalization and are suitable only for a small group of patients.

The NIPS method involves the implantation of a small port system under the abdominal skin. “The system consists of a small chamber with a membrane and a tube connected to it that leads into the abdominal cavity,” explains Professor Beate Rau, Head of Special Oncological Surgery at MHH. Through this access point, chemotherapy drugs can be distributed directly inside the abdomen.

“We can perform it on an outpatient basis and at the same time as systemic chemotherapy,” adds PD Wirth. The drugs for intravenous and intraperitoneal administration can be tailored individually, reducing the need for hospital stays and improving quality of life for patients.

The MHH team, including Professor Rau, PD Wirth, PD Anna Saborowski, and Dr. Franziska Köhler, is already treating its first patients. Over nine weeks, they receive weekly NIPS sessions before physicians evaluate whether the tumors have shrunk enough for surgical removal.

The MHH team plans to treat around ten patients annually using this new approach.

MEDICA-tradefair.com; Source: Hannover Medical School