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PIPAC is a newer way to deliver chemotherapy directly to cancers that have spread to the lining of the abdomen. Using a minimally invasive procedure, chemotherapy is sprayed as a fine mist to improve drug delivery while reducing side effects. Learn how PIPAC works, who may benefit, how it differs from HIPEC, and why it is being studied in clinical trials.

A new feasibility study found that ultrasound-guided progressive pneumoperitoneum (PPP) allowed patients with "non-accessible" abdomens to safely receive PIPAC, a treatment for peritoneal carcinomatosis. While only five patients were studied, all successfully underwent PIPAC without major complications, suggesting this technique may expand treatment options for selected patients.

The CHARLIE-2 trial is the first randomized study to directly compare HIPEC and PIPAC, two methods of delivering chemotherapy directly into the abdomen for patients with peritoneal carcinomatosis. Researchers will evaluate safety, quality of life, treatment response, and cost to determine which approach may provide the greatest benefit for patients who are not candidates for complete tumor-removal surgery.

Safety and Efficacy of Cisplatin and Doxorubicin Pressurized Intraperitoneal Aerosolized Chemotherapy (PIPAC) in Patients with Ovarian Cancer with Peritoneal Metastases: A Multicenter US Phase I Trial. Authors : Nakamura, B., Senguttuvan, R., Ruel, N.H. et al. Ann Surg Oncol 33 , 415–425 (2026). https://doi.org/10.1245/s10434-025-18432-0 A New Way to Treat Cancer Spread in the Abdome n This study looked at a treatment called Pressurized Intra-Peritoneal Aerosol Chemother