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This regional chemotherapy regimen consists of cisplatin and mitoxantrone administered via isolated thoracic perfusion with chemofiltration (ITP-F). Developed at Medias Klinikum for Surgical Oncology, the treatment is specifically designed for patients with pretreated and progressive malignant pleural mesothelioma who have exhausted standard systemic options. The procedure involves isolating the thoracic circulation using balloon catheters inserted via femoral access to block the aorta and inferior vena cava, allowing for drug concentrations 3-4 times higher than systemic administration. Following a 15-minute perfusion period, hemofiltration is performed for 45 minutes to remove the cytotoxic agents from the isolated circuit, thereby minimizing systemic toxicity. Cisplatin acts as a DNA crosslinking agent, while mitoxantrone is an anthracenedione that intercalates DNA and inhibits topoisomerase II, providing a synergistic cytotoxic effect within the isolated thoracic compartment.
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