CLINICAL REPORTSFeasibility of using intraperitoneal epinephrine and cisplatin in patients with advanced peritoneal carcinomatosisMolucon-Chabrot, Cécile; Isambert, Nicolas; Benoit, Laurent; Zanetta, Sylvie; Fraisse, Jean; Guilland, Jean-Claude; Royer, Bernard; Monin-Baroille, Pascale; Flesch, Michel; Fargeot, Pierre; Coudert, Bruno; Mayer, Françoise; Fumoleau, Pierre; Chauffert, BrunoAuthor Information GF Leclerc Regional Anticancer Center, Dijon Cedex, France Correspondence to B. Chauffert, George-Francois Leclerc Regional Anticancer Center, 1 Rue du Professeur Marion, BP 77980, 21079 Dijon Cedex, France. Tel: +33 3 80 73 75 06; fax: +33 3 80 73 77 74; e-mail: [email protected] Sponsorship: This study was supported by a grant from the Programme Hospitalier de Recherche Clinique 2001 and by the Comité de la Nièvre de la Ligue Nationale contre le Cancer. This study was presented as a poster at the ASCO 2004 meeting (abstract 5049). Received 30 April 2006 Revised form accepted 22 July 2006 Anti-Cancer Drugs: November 2006 - Volume 17 - Issue 10 - p 1211-1217 doi: 10.1097/01.cad.0000236309.66080.3b Buy Metrics Abstract Intraperitoneal epinephrine above 1 mg/l concentration has been shown to enhance the intratumoral accumulation and antitumor activity of intraperitoneal cisplatin in rats with advanced peritoneal carcinomatosis. The aim of this study was to determine the tolerance of intraperitoneal epinephrine combined with intraperitoneal cisplatin in patients with advanced peritoneal carcinomatosis (17 ovarian cancers, one peritoneal mesothelioma). Intraperitoneal epinephrine (1–5 mg/l) and cisplatin (50 mg/l; 100 mg total dose) were infused in 2 l of saline solution over 2 h. The maximal tolerated concentration of intraperitoneal epinephrine was not reached at 5 mg/l. Cardiovascular symptoms were infrequent and not strictly related to the epinephrine concentration. Tumor responses were obtained in some patients with disease resistant to intravenous platinum compounds. This work demonstrates for the first time that intraperitoneal epinephrine at sufficient concentration enhances the cisplatin effect and can be safely infused into the peritoneal cavity of patients with peritoneal carcinomatosis. The greatest limitation was abdominal pain and limited intraperitoneal distribution of the peritoneal fluid in this closed-abdomen procedure. © 2006 Lippincott Williams & Wilkins, Inc.