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Searching in the ClinicalTrials.gov registry, we found 1 clinical trial completed in Germany (PIPAC-GA01),
but 4 more trials recruiting: 1 in Italy, 1 in Singapore, 1 in Germany and the last 1 in 14 countries. PIPAC-
GA01 is a clinical trial with 35 patients where cisplatin and doxorubicin will be applied in 3 single doses in
6 weeks intervals. The safety and efficacy in terms of the clinical benefit rate will be accessed, but no results
were published yet.

At this stage, it is not possible to define indications and contraindications for PIPAC. The authors think that
this method could be a good option for patients who have done systemic chemotherapy with severe side
effects, patients with renal failure, hepatic failure or patients with cardiac toxicity. On the other hand, it is no
option for patients with end-stage disease or malignant pleural effusion.

PIPAC was tested mainly in ovarian cancer, gastric cancer and colon cancer, and it seems feasible in most
patients with refractory carcinomatosis of various origins. There were no consistent studies comparing what
type of cancer will benefit the most with this technique.

This procedure could be a new palliative treatment option because it may increase quality of life. The next
step should be the appliance of this technique in patients in an early stage of peritoneal carcinomatosis to
access the efficacy.

DECLARATIONS
Authors’ contributions
Concept and design of the review, article analysis and interpretation: all authors
Drafting the manuscript: Macedo F, Ladeira K
Manuscript revising: Longatto-Filho A, Martins SF
Approved the final version to be published: all authors

Data source and availability
All the information analysed during the current study are available in the Pubmed Repository (https://www.
ncbi.nlm.nih.gov/pubmed/).

Financial support and sponsorship
None.

Conflicts of interest
There are no conflicts of interest.

Patient consent
Not applicable.

Ethics approval
Not applicable.

Copyright
© The Author(s) 2018.

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