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Pressurized IntraPeritoneal Air-flow Chemotherapy (PIPAC) is a localized drug delivery technique used to treat peritoneal carcinomatosis. In the PI-CaP clinical trial protocol developed by the Fondazione del Piemonte per l'Oncologia, chemotherapy agents—specifically oxaliplatin or a combination of cisplatin and doxorubicin—are administered as a pressurized aerosol directly into the abdominal cavity during laparoscopy. This method utilizes a high-pressure injector and a nebulizer to create a capnoperitoneum of therapeutic aerosol, which enhances the penetration of cytotoxic agents into peritoneal tumor nodules and ensures a more uniform distribution compared to conventional liquid intraperitoneal chemotherapy. The approach is primarily investigated for patients with advanced peritoneal surface malignancies originating from gastric, colorectal, or ovarian cancers, as well as primary peritoneal tumors, aiming to maximize local efficacy while minimizing systemic toxicity.
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