Peritoneal Carcinomatosis represents a formidable challenge in oncology, characterized by its aggressive nature, limited therapeutic efficacy, and overall poor prognosis. At Protheragen, we offer a robust portfolio of services designed to accelerate the development of innovative diagnostic and therapeutic solutions for peritoneal carcinomatosis.
Overview of Peritoneal Carcinomatosis
Peritoneal Carcinomatosis is a secondary cancer that features the extensive spread of cancer cells throughout the peritoneal cavity. It often stems from colorectal, gastric, and gynecological cancers and is linked to a poor prognosis and limited therapeutic choices. The peritoneum, a thin membrane covering the abdominal cavity, offers an ideal environment for tumor cells to adhere, invade, and multiply. This condition is typified by the presence of malignant ascites, which severely impacts quality of life and lowers the median overall survival to 2–5 months.
Fig.1 A case of computed tomography (CT) analysis of peritoneal carcinomatosis. (Liu X.,
et al., 2023)
Pathogenesis of Peritoneal Carcinomatosis
The pathogenesis of peritoneal carcinomatosis involves several key mechanisms. Tumor cells metastasize to the peritoneum through the bloodstream, lymphatic system, or direct invasion from adjacent organs. Once in the peritoneal cavity, these cells adhere to the mesothelial lining and invade the underlying tissue. Angiogenesis, the formation of new blood vessels, supports tumor growth. Additionally, tumor cells evade the immune system, undergo epithelial-mesenchymal transition (EMT), and produce cytokines and growth factors that promote further proliferation and invasion. Interleukin-6 (IL-6) and its soluble receptor (sIL-6Rα) have been identified as potential therapeutic targets due to their high concentrations in the peritoneal cavity of patients with peritoneal carcinomatosis.
Diagnostics Development for Peritoneal Carcinomatosis
Blood Tests and Proteomics
Machine learning models utilizing basic blood parameters can predict the presence of peritoneal carcinomatosis. Proteomic analysis identifies specific protein signatures associated with the disease, offering a non-invasive diagnostic approach. For instance, studies have identified a 10-protein signature that predicts the occurrence of peritoneal carcinomatosis in gastric cancer patients, with an area under the curve (AUC) of 0.83.
Pathological Diagnosis
Histopathology and cytopathology remain the gold standard for diagnosing peritoneal carcinomatosis. Digital pathology and deep learning models analyze histopathological images to improve diagnostic accuracy. For example, a deep learning model for ascites cytopathology achieved an average accuracy of 0.8316 and an AUC of 0.8851 in classifying malignant cells.
Therapeutics Development for Peritoneal Carcinomatosis
Targeted therapies zero in on particular molecular mechanisms implicated in peritoneal carcinomatosis. IL-6 inhibitors, including tocilizumab and siltuximab, are currently under clinical trial scrutiny for their potential application in treating this disease. These medications are designed to interfere with the IL-6 signaling pathway, which plays a vital role in tumor growth and immune evasion.
Immunotherapies, including immune checkpoint inhibitors, CAR-T cells, and cancer vaccines, are being explored to enhance the immune response against tumor cells. Clinical trials are ongoing to evaluate the efficacy of these therapies in treating peritoneal carcinomatosis.
Systemic and intraperitoneal chemotherapy are standard therapeutics for peritoneal carcinomatosis. New drug delivery systems, such as magnetically controlled drug targeting (MCDT), are being developed to improve the efficacy of chemotherapy by increasing drug penetration into tumor tissue.
Table 1. Therapeutics of Peritoneal Carcinomatosis.
| Therapeutics |
Target |
Description |
Stage |
| Hyperthermic Intraperitoneal Chemotherapy (HIPEC) |
Tumor cells |
Chemotherapy agents heated to 41-43°C are instilled into the peritoneal cavity to increase cytotoxicity and destroy tumor cells. |
Approved |
| Early Postoperative Intraperitoneal Chemotherapy (EPIC) |
Tumor cells |
Chemotherapy is administered in the early postoperative period directly into the peritoneal cavity. |
Approved |
| Bidirectional/Neoadjuvant Intraperitoneal and Systemic Chemotherapy (BIPSC/NIPS) |
Tumor cells |
Combination of neoadjuvant systemic and intraperitoneal chemotherapy followed by CRS, HIPEC, and EPIC. |
Approved |
| Various Chemotherapeutic Agents |
Systemic Tumor Cells |
Systemic chemotherapy for patients unable to undergo surgery, targeting tumor cells through the bloodstream. |
Approved |
| Catumaxomab |
EpCAM, CD3 |
Monoclonal antibody targeting epithelial cancer cells and T cells to enhance the immune response. |
Preclinical |
| Chimeric Antigen Receptor (CAR)-T Cells |
PD-L1, TAG72 |
Engineered T cells targeting specific antigens on tumor cells. |
Preclinical |
Disclaimer: Protheragen focuses on providing preclinical research services. This table is for information exchange purposes only. This table is not a treatment plan recommendation. For guidance on treatment options, please visit a regular hospital.
Our Services
At Protheragen, we provide a comprehensive suite of services aimed at speeding up the creation of cutting-edge diagnostic and therapeutic approaches for peritoneal carcinomatosis. Our capabilities cover the full range of preclinical research, including target identification and validation, lead optimization, and efficacy studies. With our advanced technologies and a team of experienced biological experts, we offer our clients thorough and reliable support.
Diagnostics Development
- Karyotype Analysis Service
- Omics Analysis Service
- Biomarker Development Service
- Artificial Intelligence Service
- Customized Diagnostics Development
Therapeutic Development
- Anticancer Peptide
- Gene Therapy
- Immunotherapy
- Monoclonal Antibody
- Phytotherapy
- Small Molecule Drug
- Therapeutic Cancer Vaccine
Disease Models
- Human Xenograft Models
- p53LSL-R172H/+ Dicer1floxflox Ptenfloxflox Amhr2cre/+ Triple-mutant (TKO) Mouse Models
- shRNA-p53, AKT, and c-Myc Overexpression Models
Protheragen offers an extensive array of preclinical research services tailored for peritoneal carcinomatosis. These services encompass in vitro and in vivo studies, biomarker discovery, and drug sensitivity assays. Our goal is to fast-track the creation of innovative diagnostic tools and therapeutic solutions, helping our clients maintain a leading edge in medical advancements. If you are interested in our services, please feel free to
contact us.
References
- Szadkowska, Małgorzata, Jakub Pałucki, and Andrzej Cieszanowski. "Diagnosis and treatment of peritoneal carcinomatosis–a comprehensive overview." Polish journal of radiology 88.1 (2023): 89-97.
- Dadgar, Neda, et al. "Targeting interleukin-6 as a treatment approach for peritoneal carcinomatosis." Journal of Translational Medicine 22.1 (2024): 402.
All of our services and products are intended for preclinical research use only and cannot be used to diagnose, treat or manage patients.
