intraperitoneal chemotherapy + simvastatin

This is a combination therapy consisting of intraperitoneal chemotherapy and simvastatin. Intraperitoneal chemotherapy involves the direct administration of chemotherapeutic agents into the peritoneal cavity, commonly used for treating cancers within the abdominal cavity such as ovarian cancer. Simvastatin is a small molecule statin primarily used to lower cholesterol by inhibiting HMG-CoA reductase in the mevalonate pathway, but it has demonstrated potential anti-tumor effects in preclinical and clinical studies. The rationale for combining simvastatin with chemotherapy is based on evidence that statins can enhance chemosensitivity, overcome drug resistance, induce apoptosis, inhibit tumor cell proliferation and migration, and potentially improve clinical outcomes when added to standard chemotherapeutic regimens[1][2][4][5]. Mechanistically, simvastatin may potentiate chemotherapy by inhibiting pathways involved in cancer cell survival (such as Ras/Rho GTPases), reducing inflammation and angiogenesis, suppressing metastasis-related proteins (e.g., matrix metalloproteinases), and modulating drug efflux mechanisms[1][4][5]. This combination has been investigated in various cancers including ovarian cancer (with intraperitoneal delivery), breast cancer (with systemic chemo), osteosarcoma, small cell lung cancer (systemic route), among others[1][2][4][5].