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This investigational combination therapy involves the regional delivery of mitomycin C via pressurized intraperitoneal aerosolized chemotherapy (PIPAC) in conjunction with systemic FOLFIRI (fluorouracil, irinotecan, and leucovorin) and bevacizumab. Developed by City of Hope Medical Center, this approach is designed to treat unresectable peritoneal metastases arising from appendiceal or colorectal carcinomas. Mitomycin C acts as a DNA alkylating agent that cross-links DNA to inhibit cancer cell proliferation. The PIPAC delivery method uses a pressurized aerosol to enhance drug penetration into peritoneal tumor tissues. Systemic FOLFIRI provides cytotoxic effects through thymidylate synthase and topoisomerase I inhibition, while bevacizumab targets vascular endothelial growth factor (VEGF) to inhibit angiogenesis.
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