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Liposomal irinotecan + rmhTNF-NC is an investigational combination therapy currently being evaluated for the treatment of malignant ascites (malignant peritoneal effusion), particularly those secondary to digestive system tumors. The regimen consists of a liposomal formulation of irinotecan, a topoisomerase I inhibitor, and a recombinant mutant human tumor necrosis factor (rmhTNF-NC). Irinotecan is a prodrug that is converted to the active metabolite SN-38, which stabilizes topoisomerase I-DNA covalent complexes, leading to double-strand DNA breaks and cell death. The liposomal delivery system encapsulates the drug in lipid bilayer vesicles to prolong systemic exposure and enhance accumulation within tumor tissues. rmhTNF-NC is a cytokine designed to induce apoptosis in tumor cells and potentially increase the permeability of tumor vasculature to improve chemotherapy delivery. This combination is administered via intraperitoneal injection to achieve high local drug concentrations within the peritoneal cavity, aiming to control fluid accumulation and target peritoneal metastases in patients who have failed standard systemic therapies.
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