Pressurized Intraperitoneal Aerosolized Chemotherapy: Operationalizing From a Pharmacy Perspective at a Large Academic Medical Center

Presenting Authors: Aimee Merkert, PharmD, and Megan Hinton, PharmD, The University of Vermont Medical Center, Burlington, VT

BACKGROUND: Intraperitoneal chemotherapy has been available for the treatment of peritoneal metastases and primary peritoneal cancers for almost 7 decades. Pressurized intraperitoneal aerosolized chemotherapy (PIPAC) was developed in Europe and has only recently been offered in the United States. PIPAC provides an alternative for patients who do not qualify for hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery.

OBJECTIVE: To describe pharmacy involvement in the implementation of PIPAC at The University of Vermont Medical Center (UVMMC).

METHODS: The investigators describe the compounding procedures for chemotherapy, mechanics of instillation via a single-chamber power injector, supportive medications needed before and/or after cytoreductive surgery, and the safety protocols used for PIPAC in the operating room.

RESULTS: The first 2 patients at UVMMC received PIPAC with cisplatin and oxaliplatin in fall 2024. One patient subsequently qualified for HIPEC, and the other is continuing PIPAC and systemic chemotherapy.

CONCLUSION: The investigators developed compounding procedures and a line setup for loading the power injector, and collaborated on safety procedures in the operating room to successfully and safely implement PIPAC at UVMMC. With this, UVMMC became one of the first hospitals in the nation to implement this procedure.

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