Peritoneal Cancer Medication

Updated: Dec 22, 2019
  • Author: Wissam Bleibel, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to induce remission, to prevent complications, and to reduce morbidity. The current approach favors intraoperative use of heated chemotherapeutic drugs. A variety of chemotherapeutic and antiangiogenic drugs is used.

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Chemotherapeutic agents

Class Summary

These drugs inhibit cell growth and proliferation.

Cisplatin (Platinol)

Inhibits DNA synthesis and thus cell proliferation by causing DNA cross-links and denaturation of double helix.

Doxorubicin (Adriamycin, Rubex)

Inhibits topoisomerase II and produces free radicals, which may cause the destruction of DNA. Combination of these events can, in turn, inhibit the growth of neoplastic cells.

Carboplatin (Paraplatin)

Analog of cisplatin. Has same efficacy as cisplatin but with better toxicity profile.

Dose is based on following formula:

Total dose (mg) = (target AUC) X (GFR = 25), where AUC (area under plasma concentration-time curve) is expressed in mg/mL/min and GFR (glomerular filtration rate) is expressed in mL/min.

Cyclophosphamide (Neosar, Cytoxan)

Chemically related to nitrogen mustards. As an alkylating agent, the mechanism of action of the active metabolites may involve cross-linking of DNA, which may interfere with growth of normal and neoplastic cells.

Paclitaxel (Taxol)

Mechanisms of action are tubulin polymerization and microtubule stabilization.

Bevacizumab (Avastin)

Bevacizumab is a recombinant humanized monoclonal antibody to vascular endothelial growth factor (VEGF) receptors. Blocking the angiogenic VEGF receptor, in turn inhibits tumor angiogenesis, starving tumor of blood and nutrients. It is indicated in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan for platinum-resistant recurrent epithelial ovarian cancer in patients who received no more than 2 prior chemotherapy regimens. It is also indicated for women with platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer either in combination with carboplatin and paclitaxel or in combination with carboplatin and gemcitabine chemotherapy, followed by bevacizumab alone.

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