Optimal drugs for HIPEC in different tumors.

Although there is adequate evidence to support treatment of primary and secondary peritoneal surface malignancies with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC), the latter procedure is still far from standardized and optimization of its aspects may be warranted. Significant variations remain in HIPEC procedures and include also the drug choice. In this manuscript the characteristics of the optimal HIPEC drug will be discussed. Subsequently, the drug choice for HIPEC treatment of different peritoneal surface malignancies will be briefly analyzed. Prospective randomized trials are warranted to determine which drug is the most effective for HIPEC in each type of peritoneal surface malignancy. In the future, it would be of major significance when the choice of the most optimal drug in HIPEC may be tailored to the patient's individual tumor by adequate drug sensitivity testing of the tumor cells.