ArticleAnnals of surgical oncology2026
Intra-Tumoral Mucolytic Therapy for Unresectable Pseudomyxoma Peritonei: Results of a Single-Center Expanded Access Program.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Single-Cell Transcriptomic Analysis of Tumor Heterogeneity and the Microenvironment in Pseudomyxoma Peritonei.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
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8 authors.
Funding
Abstract
backgroundFor patients with unresectable pseudomyxoma peritonei (PMP), intra-tumoral administration of a mucolytic drug combination comprising bromelain and acetylcysteine (BromAc) reduced mucinous tumor volume in phase 1/2 non-U.S. TRIALS: This report describes the initial outcomes of an expanded access BromAc treatment program at a single U.S. center.
methodsEligible patients with progressive unresectable PMP underwent image-guided placement of percutaneous catheters in one or more mucinous tumors. BromAc was administered via the catheters, and after a 24 h dwell period, the dissolved mucus was aspirated. This treatment was repeated up to six times per tumor. Changes in tumor volume, post-treatment complications, and patient-reported quality-of-life (QOL) symptoms were recorded.
resultsTen appendiceal PMP patients with 23 individual tumors underwent 107 intra-tumoral BromAc treatments (median, 4 treatments; interquartile range [IQR], 4-6 treatments per tumor). The median pre-treatment tumor volume by imaging was 728 ml (IQR, 350-2104 ml). Among eight patients that completed post-treatment imaging, 14 (82.4 %) of 17 tumors exhibited a reduction in tumor volume (median tumor volume reduction, 48.6 %; IQR, 14.9-75.4 %). The median cumulative volume of dissolved mucus aspirated after treatment completion was 370 ml (IQR, 155-756 ml). There were 6 CTCAE grade 1, 20 grade 2, and 6 grade 3 adverse events. Two patients died within 40-days after protocol initiation from disease progression, clinical deterioration, or both. Seven patients completed post-treatment QOL surveys, with four patients (57.1 %) reporting improved symptoms.
conclusionsRepeated intra-tumoral BromAc administration decreases mucinous tumor volume and may improve short-term QOL symptoms. Tumor characteristics influence treatment response, whereas patient factors impact safety and tolerability of therapy.
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