A novel perspective for an orphan problem: old and new drugs for the medical management of malignant ascites

Crit Rev Oncol Hematol. 2011 Aug;79(2):144-53. doi: 10.1016/j.critrevonc.2010.07.016. Epub 2010 Aug 13.

Abstract

Malignant ascites is defined as a condition in which fluid containing cancer cells accumulates in the abdomen. The cancers most commonly associated to ascites are ovarian (37%), pancreato-biliary (21%), gastric (18%), oesophageal (4%), colorectal (4%), and breast (3%). Treatment of malignant ascites remains a challenge. In the majority of patients systemic chemotherapy is ineffective and diuretics and paracentesis are still the only approaches, but new promising option are appearing, as cytoreductive debulking surgery and intraperitoneal (IP) or intravenous biological (target) therapies. More promising, after the recognition of potential epithelial targets as Epithelial Cell Adhesion Molecule (EpCAM), are the trifunctional antibodies able to bind these cell adhesion molecules and, at the same, time the immune system cells. These agents have been developed for malignant ascites with the aim also to prolong the need for subsequent paracentesis. So patients with malignant ascites may look at the future with hope and growing optimism.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Antibodies, Bispecific / immunology
  • Antibodies, Bispecific / therapeutic use*
  • Antigens, Neoplasm / immunology
  • Antigens, Neoplasm / metabolism
  • Ascites / drug therapy*
  • Ascites / epidemiology
  • Ascites / etiology
  • Ascites / pathology
  • Cell Adhesion Molecules / immunology
  • Cell Adhesion Molecules / metabolism
  • Combined Modality Therapy / methods*
  • Diuretics / therapeutic use
  • Drug Administration Routes
  • Enzyme Inhibitors / administration & dosage*
  • Female
  • Humans
  • Matrix Metalloproteinase Inhibitors*
  • Matrix Metalloproteinases / metabolism
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / pathology
  • Paracentesis
  • Peritoneal Neoplasms / complications
  • Peritoneal Neoplasms / epidemiology
  • Peritoneal Neoplasms / pathology
  • Somatostatin / administration & dosage*
  • Somatostatin / analogs & derivatives
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / pathology

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Bispecific
  • Antigens, Neoplasm
  • Cell Adhesion Molecules
  • Diuretics
  • Enzyme Inhibitors
  • Matrix Metalloproteinase Inhibitors
  • Somatostatin
  • Matrix Metalloproteinases