Cancer spread throughout the abdomen – known as peritoneal metastasis – is common in advanced gynecologic and gastrointestinal cancers globally and has a very poor prognosis. Intraperitoneal (IP) chemotherapy pumped directly into the abdomen can increase survival, but it has to be given through catheters at high doses by specially trained medical staff in dedicated cancer centers. IP chemotherapy is therefore rarely an option in India because it is resource-intensive and its toxicity is not well tolerated by the patient population.
The aim of this research is to develop implants for IP chemotherapy that make it more accessible and cost-effective while minimizing its side effects. These implants will be made of readily available materials, will deliver generic chemotherapeutic drugs commonly used in India, and will be designed for minimally invasive laparoscopic placement.
Our proposed solution can be adopted by tertiary hospitals throughout the country as they already have the infrastructure for laparoscopic surgeries and chemotherapeutic management of cancer patients. We see an opportunity to serve not only cancer patients that receive therapeutic treatment but also those that have a terminal disease and receive palliative treatment: IP drug delivery can help manage many symptoms for a better quality of life.
Collaborations have been set up with GI/gynecologic oncology departments at Tata Memorial Hospital in Mumbai and Manipal Hospital in Bangalore, both leading hospitals in the field of IP chemotherapy in India. At these hospitals, we are shadowing physicians to understand patient management and carrying out design feedback reviews for our implant prototypes. Benchtop implant development is underway at our lab at MIT, where we are currently using animals to test tolerability and drug delivery of our biomaterials. The next animal studies will explore antitumor efficacy in animal models of peritoneal metastasis. At the same time, we are creating large-scale device prototypes that can be deployed through laparoscopic tools. The biocompatibility, drug delivery and efficacy animal data, as well as our large-scale prototypes, will be presented to our clinician collaborators for feedback reviews in India this summer, to move closer to our final deliverable.