How eIPADD transforms drug delivery in peritoneal treatment: A preclinical investigation of distribution and penetration using a conductive box model

Sareen Amrit, 2025
Imagine this: cancer cells from another part of the body travel to the peritoneum, the thin membrane that lines your abdomen, setting up camp and spreading. This condition, known as peritoneal metastasis (PM), is common in cancers like ovarian, gastric, and colorectal cancer. Unfortunately, the outlook for patients with PM hasn’t been great, with limited treatment options and poor survival rates. The go-to method? A combination of surgery to remove as much of the tumor as possible (called debulking) followed by Hyperthermic Intraperitoneal Chemotherapy (HIPEC), where heated chemo drugs are delivered straight into the abdomen to eliminate the remaining cancer cells. But not all patients can be treated this way. Sometimes the cancer is spread too far, and debulking followed by HIPEC just isn’t an option. Until recently, their only choice was intravenous chemotherapy—a solution that pumps chemo into the bloodstream to attack the cancer but unfortunately brings a host of side effects by targeting healthy cells along the way. Enter a game-changing technique: Intraperitoneal Aerosolized Drug Delivery, or IPADD. This method allows chemotherapy to be sprayed directly into the abdominal cavity as an aerosol. Picture a fine mist of chemo, delivered right where it’s needed, distributing more evenly than traditional liquid methods. The beauty of this approach is that it allows high doses of the drug to hit the cancer directly while sparing the rest of the body from harmful side effects. But as clever as it sounds, IPADD has its own hurdles—like how to get the drug to evenly coat all areas of the abdomen. Here’s where things get even more interesting. A new technique called Electrostatic Precipitation has been introduced to the mix. By adding an electric field, the aerosolized drug particles can be pulled across the abdominal cavity, ensuring a more even distribution, regardless of where the spray is coming from. This master’s thesis set out to test just how effective this enhanced method—eIPADD—could be. The research took healthy and cancerous peritoneal tissue (donated by patients during surgery) and placed it in an aluminum box designed to mimic the human abdomen. Instead of real chemotherapy, blue ink was used to see how deeply the aerosol penetrated the tissue after the eIPADD procedure was performed. So, what did they find? The results showed that electrostatic precipitation led to better distribution and deeper tissue penetration, meaning that more of the drug could reach the cancer cells in the critical areas. While this is exciting news, the research is still in its early days. More work is needed to fine-tune the technique and make sure it’s safe for use in real-world treatments. Still, the promise is clear—eIPADD could offer new hope to patients with peritoneal metastasis who are running out of options.

Promotor Wim Ceelen
Opleiding Geneeskunde
Domein Chirurgie
Kernwoorden cancer peritoneum metastasis electrostatic precipitation aerosol IPADD PIPAC drug distribution drug penetration surgery chemotherapy