DISEASE RESPONSE AND SCLEROTIC LOSS OF DOMAIN AFTER 8 PIPAC (PRESSURIZED INTRA-PERITONEAL AEROSOL CHEMOTHERAPY) TREATMENTS: A CASE REPORT.

A 63-year-old male with peritoneal metastases from appendiceal cancer underwent 8 PIPAC treatments in a US Phase 1 trial. Results initially showed reduced CEA levels and tumor size. However, repeated PIPAC sessions caused severe peritoneal sclerosis and scarring, affecting visibility and access during successive procedures, limiting further treatment. Although tumor lesions decreased in size and number, there was no clear Peritoneal Regression Grading Score (PRGS) response, suggesting a need to evaluate the long-term balance between PIPAC efficacy and adverse effects.