AIIMS develops new drug delivery system for cancer

NEW DELHI: Doctors at AIIMS have introduced a new technology for treating cancers affecting the abdominal lining, for example colon cancer or colorectal cancer. It involves administering heated chemotherapy drugs directly into the abdomen during surgery.
Usually, chemotherapy drugs are infused into the veins post-surgery to destroy cancer cells. With the new technology, doctors said they were able to deliver higher dosage of chemotherapy drugs.

“It leads to significant improvement in the survival rate of patients,” Dr S V S Deo, head of surgical oncology at the institute, told TOI.

The technology known as hyperthermic intraperitoneal chemotherapy (HIPEC) has been used on experimental basis in western countries for nearly two decades. But in India it gained ground only recently, said Dr Deo.

At AIIMS, he added, they conducted HIPEC for the first time in 2013 on a 35-year-old woman suffering from peritoneal cancer.

“We were not sure about the outcome then but still went ahead because we wanted to save her. The heating of chemotherapy drugs had to be done manually and it was pumped inside the patient post-surgery via the heart and lung machine. She is still alive,” Dr Deo said. The accidental success was followed by further trials on nearly 100 patients who underwent HIPEC at the institute using the standard machine which has in-built mechanism for heating, temperature control and delivery of chemotherapy drugs in cancers involving the peritoneal surface.

“The mortality rate during surgery has gone down from 10% to 2-3%. Overall survival rate has improved by 30 to 40% using the new technology,” the head of surgical oncology said.

Some private hospitals in India also offer HIPEC but it is expensive. AIIMS offers it for free or at subsidised rates, the doctors said.

They stressed on the fact that the technology cannot be used for all cancer patients, only those with cancer affecting abdominal lining. Also, it has to be conducted at a centre with high skilled and experienced professionals given that any variation of drug dosage or temperature control can be fatal. AIIMS recently held a workshop at the institute to train young surgeons on HIPEC.

Dr Harit Chaturvedi, head of surgical oncology at Max Saket, said they have used HIPEC in 75 cases. “The initial results are encouraging. HIPEC has improved the outcome in many cases. However, long term gains are yet to be assessed,” he said.

Colorectal cancer is one of the most common cancers in men and its incidence is on the rise mainly on account of bad food habits. Ovarian cancer is the third most common among women. HIPEC, doctors said, may bring hope for many patients suffering from them.