Molecular Diagnostics, PIPAC Appear 'Exciting' in GI Cancer Surgical Care

Novel interventional strategies like intraperitoneal aerosolized chemotherapy may become “practice-changing” for peritoneal surface cancers, according to Thinzar Min Lwin, MD, MS.

Lwin, a gastrointestinal cancer surgical oncologist and assistant clinical professor in the Division of Surgical Oncology of the Department of Surgery at City of Hope in Duarte, California, spoke with CancerNetwork® about developments presented at the 2025 Society of Surgical Oncology Annual Meeting that may impact the surgical oncology field. Of note, she emphasized an increasing use of molecular diagnostics, which may help with prognosis and predictions of patient outcomes to treatment.

Additionally, she highlighted a study that colleagues from her institution conducted in which the use of mitomycin C pressurized intraperitoneal aerosolized chemotherapy demonstrated potential use as a treatment for patients with appendiceal and colorectal carcinomatosis.

Transcript:

There is a lot of very exciting research that’s happening in the surgical oncology world, and it’s always great to see what everyone’s doing at annual meetings like [SSO]. What we are finding more and more with each subsequent meeting is that there is an increasing use of molecular diagnostics to be able to prognosticate patients and to help predict patient outcomes. We had seen this integrated with liquid biopsy and circulating tumor DNA, but now more so on a specimen level, we are able to do more. We’re able to do spatial transcriptomics [and] multiplex immunohistochemistry from patient samples that surgeons are collaborating with our scientists and our pathology colleagues about, and that’s going to reveal a lot more information on their outcomes. That’ll be very interesting to follow.

As far as interventional [developments], I would be remiss not to mention City of Hope’s study using aerosolized intraperitoneal chemotherapy. We’re doing this in metastatic colorectal cancer, appendiceal cancer, and ovarian cancer with our GI [gastrointestinal] and GYN [gynecologic] colleagues. That has the potential to be practice-changing in the way that we deal with peritoneal surface cancers.

Reference

Raoof M, Fakih M, Sullivan K, et al. Dose escalation phase 1 trial of mitomycin C pressurized intraperitoneal aerosolized chemotherapy in combination with systemic chemotherapy for unresectable appendiceal and colorectal carcinomatosis. Presented at the Society of Surgical Oncology 2025 Annual Meeting; March 27-29, 2025; Tampa, FL. Abstract 55.