What Is NIPEC for Mesothelioma?
NIPEC stands for normothermic intraperitoneal chemotherapy. It’s a type of chemotherapy wash placed directly into the abdomen at normal body temperature (normothermic). Because peritoneal mesothelioma forms on the surface of the abdominal lining, placing chemotherapy directly in that space allows doctors to treat the cancer more directly.
Instead of traveling through the bloodstream like traditional IV chemotherapy, NIPEC delivers cancer-fighting medications directly into the peritoneal cavity (the open space around the abdominal organs). This allows higher concentrations of chemotherapy to reach cancer cells along the abdominal lining.
Mesothelioma doctors may recommend NIPEC because it can:
- Target cancer cells left behind after mesothelioma surgery
- Deliver chemotherapy directly to the abdominal lining
- Be combined with systemic (whole-body) chemotherapy
NIPEC doesn’t replace systemic chemotherapy. Instead, it’s often used as an additional cancer treatment. You may also hear NIPEC referred to as postoperative intraperitoneal chemotherapy or NIPEC-LT (long-term NIPEC) when it’s given in repeated cycles over several months.
Download our Free Peritoneal Mesothelioma Guide to learn more about treatments like NIPEC and prepare for conversations with your doctor.
NIPEC and Peritoneal Mesothelioma: How It Works & What to Expect
NIPEC works by administering a chemotherapy solution directly to the lining of the abdomen at normal body temperature. Even after surgery removes visible tumors, there can be very small clusters of cancer cells left behind on the abdominal surface. The goal of NIPEC treatment for mesothelioma is to destroy these remaining cancer cells.
Step 1: Cytoreductive Surgery to Remove Visible Tumors
Your treatment usually begins with cytoreductive surgery. During this operation, the surgeon will remove as much visible mesothelioma cancer as possible from the lining of the abdomen.
In many cases, patients also receive HIPEC (heated intraperitoneal chemotherapy) during this same surgery. HIPEC is a one-time treatment where surgeons circulate a heated chemotherapy solution throughout the abdomen before the operation is completed.
Step 2: Placement of a Chemotherapy Port
While you’re still in surgery, the surgeon will place a small intraperitoneal port or catheter under your skin, usually in the abdomen or chest area.
You won’t need to do anything during this step since it’s done while you are under anesthesia. After surgery, you may notice a small raised area under the skin where the port is located. This port allows chemotherapy to be given later without you having to undergo another surgery.
Step 3: Recovery in the Hospital and at Home
After surgery, you will spend several days in the hospital before returning home. During this time, your care team will monitor your surgery sites, manage pain, and ensure your digestive system is functioning properly.
Once you’re home, you’ll continue to focus on your recovery. During this time, you may feel tired or sore. NIPEC treatment for mesothelioma doesn’t start until your body is strong enough to handle chemotherapy. The first dose of NIPEC is typically scheduled 4 to 6 weeks after cytoreduction with HIPEC.
Step 4: Starting NIPEC Treatment
When NIPEC begins, a chemotherapy infusion is delivered through the port directly into your abdominal cavity.
Treatments are usually done in an outpatient setting, meaning you can go home the same day. You may feel some pressure or fullness in the abdomen during the infusion, but your care team will monitor you closely and help manage any side effects.
Step 5: Ongoing Treatment Cycles
NIPEC is usually given every 3 weeks for 6 cycles. The number of treatments you receive will depend on your diagnosis, cancer stage, and response to therapy.
Common chemotherapy drugs used for NIPEC may include:
- Cisplatin
- Doxorubicin
- Mitomycin
- Paclitaxel
- Pemetrexed
Some patients also receive mesothelioma chemotherapy using the same drugs through an IV as part of their overall treatment.
Step 6: Follow-Up and Monitoring
After completing NIPEC treatment for mesothelioma, you’ll continue with regular follow-up appointments. These doctor visits may include more imaging tests, lab work, and physical exams to monitor your recovery and check to see if the cancer has returned.
Your mesothelioma care team will also address any long-term side effects and help you plan the next steps in your treatment.
Who May Qualify for NIPEC Treatment?
NIPEC is a specialized treatment and isn’t right for everyone with mesothelioma. Doctors carefully select patients based on several important factors.
You may be a candidate for NIPEC if:
- You have peritoneal mesothelioma.
- Your cancer can be mostly or completely removed with surgery.
- You are healthy enough to recover from major surgery and chemotherapy.
- Your cancer is mainly limited to the abdomen.
- You can get treated at a mesothelioma center experienced in NIPEC.
A mesothelioma specialist can review your medical history, cancer stage, and overall health to determine whether NIPEC is an appropriate option for you.
Use our Free Doctor Match service to connect with peritoneal mesothelioma specialists who can determine if you’re a good candidate for NIPEC treatment.
NIPEC and Mesothelioma: Side Effects
NIPEC, like all chemotherapy treatments, can cause side effects. Some side effects are related to the chemotherapy drugs themselves, while others may be related to the port used to deliver the medications.
Possible side effects of NIPEC for mesothelioma include:
- Abdominal discomfort, pressure, or bloating
- Catheter or port problems, like leaks or blockages
- Changes in blood counts
- Fatigue
- Infection or irritation around the port site
- Nausea or changes in appetite
Doctors monitor mesothelioma patients closely during NIPEC treatment and address side effects as they come up. Treatment plans can be adjusted to help manage symptoms and maintain quality of life whenever possible.
Success Rate of NIPEC for Peritoneal Mesothelioma
NIPEC is usually given as part of a multimodal treatment plan that includes surgery and systemic chemotherapy. Doctors have found that adding NIPEC can improve survival rates compared to standard treatments alone.
After cytoreductive surgery with HIPEC, the 5-year survival rate is typically around 44% to 50%. For similar patients who go on to receive NIPEC-LT after surgery and HIPEC, the 5-year survival rate is as high as 75%.
This jump in survival rate suggests that NIPEC is a powerful way to improve life expectancy. However, since NIPEC is a specialized therapy, you should talk to your doctor to confirm whether it’s the right step for your specific treatment and long-term health goals.
Studies on NIPEC and Mesothelioma
Because peritoneal mesothelioma is rare, most research on NIPEC has come from a small number of cancer centers that specialize in treating this disease. Instead of large clinical trials, doctors have learned from long-term studies of patients treated at these centers.
- Doctors studied patients at Washington Cancer Institute who received NIPEC and found that they lived longer than patients treated with standard chemotherapy alone.
- Researchers followed patients who received NIPEC multiple times after surgery to see how well they tolerated it. Many patients were able to complete NIPEC safely with manageable side effects when treated at experienced mesothelioma centers.
- Additional studies concluded that patients who continued receiving NIPEC after mesothelioma surgery and heated chemotherapy had better disease control and longer survival than what had been seen in the past with surgery or IV chemotherapy alone.
While these studies are encouraging, they also show that NIPEC tends to work best for patients who are carefully selected and treated at centers with experience using this approach. Results can vary depending on the type of tumor, how much cancer can be removed during surgery, and a person’s overall health.
What Is the Difference Between NIPEC and HIPEC?
Both HIPEC and NIPEC are treatments for peritoneal mesothelioma that deliver chemotherapy directly inside the abdomen. Instead of traveling through the bloodstream, the chemotherapy is placed right where the cancer grows.
The main differences are when the treatment is given, how warm the chemotherapy is, and how often it’s used.
| Feature | HIPEC | NIPEC |
|---|---|---|
| When it’s given | During surgery | After surgery |
| How it’s administered | Circulated in the abdomen while the surgeon is still operating | Given through a small port placed under the skin at the end of surgery |
| Chemotherapy temperature | Warmed (heated) to 103 °F | Normal body temperature (98.6 °F) |
| How often it’s used | One time only | Given multiple times |
| Length of treatment | Several hours in the operating room | Ongoing treatments over weeks or months |
| Role in treatment | Part of the main treatment for peritoneal mesothelioma | Follow-up treatment to continue fighting remaining cancer cells |
Results vary from person to person, and not everyone is a candidate for both treatments. A mesothelioma specialist can help determine which options may be appropriate for you or a loved one.
Find Out if NIPEC Could Be Part of Your Mesothelioma Treatment
Learning about treatment options for peritoneal mesothelioma can feel overwhelming, especially when therapies like NIPEC are highly specialized. You don’t have to figure this out on your own.
Our Patient Advocates work one-on-one with patients and families to help them understand their options and feel more confident as they make medical decisions.
We can help you:
- Find doctors and cancer centers experienced in mesothelioma
- Understand whether NIPEC may be part of your treatment plan
- Pursue financial compensation to help pay for expenses
- Access support groups and other resources
Reach out today at (866) 608-8933 or download our Free Peritoneal Mesothelioma Guide to learn more about NIPEC and the full range of treatment and support options available to you.
NIPEC and Mesothelioma FAQs
What is NIPEC for mesothelioma?
NIPEC (normothermic intraperitoneal chemotherapy) is a type of chemotherapy delivered directly into the abdomen at normal body temperature. It’s used after surgery for peritoneal mesothelioma to help treat cancer cells that may be too small to see or remove during surgery.
Instead of traveling through the bloodstream like IV chemotherapy, NIPEC is placed right where mesothelioma grows, along the lining of the abdomen. It is usually given through a small port placed under the skin and may be delivered over several treatment cycles.
What are the limitations of NIPEC?
NIPEC is a specialized treatment and isn’t right for everyone. Mesothelioma doctors usually recommend it only for patients whose cancer can be removed with surgery and who are healthy enough to handle ongoing chemotherapy.
Other limitations of NIPEC include:
- Careful patient selection to ensure the treatment is appropriate
- Limited availability at a small number of experienced cancer centers
- Possible side effects that vary by chemotherapy medication and overall health
- Time commitment, since treatment is given over multiple sessions
Your mesothelioma specialist will weigh the potential benefits against the risks based on your individual situation.
Does NIPEC improve survival for malignant peritoneal mesothelioma?
Early results from long-term studies suggest that adding NIPEC after cytoreductive surgery with heated chemotherapy may help some people with peritoneal mesothelioma improve their life expectancy, especially when most or all of the cancer can be removed.
That said, survival depends on several factors, including:
- How much cancer the surgeon is able to remove
- The cell type of mesothelioma and how it behaves
- Your overall health and how you respond to treatment
NIPEC isn’t a guarantee, but it may help extend life expectancy for patients treated at experienced mesothelioma cancer centers.
What drugs are used in NIPEC?
The chemotherapy drugs used in NIPEC for mesothelioma can vary depending on the treatment plan and the cancer center.
Commonly used medications include:
- Cisplatin
- Doxorubicin
- Mitomycin
- Paclitaxel
- Sometimes pemetrexed or other drugs
Your mesothelioma doctor will choose medications based on your diagnosis, prior treatments, and how well your body is expected to tolerate chemotherapy.
How can I find a cancer center that offers NIPEC?
NIPEC and long-term NIPEC (NIPEC-LT) are usually offered only at specialized cancer centers that have experience treating peritoneal mesothelioma. These programs are typically run by surgeons with advanced training and may also be involved in research or clinical trials.
Use our Free Doctor Match for help finding specialists and cancer centers that offer NIPEC treatment for mesothelioma.
Is NIPEC the same thing as HIPEC?
No. While both treatments deliver chemotherapy directly into the abdomen for peritoneal mesothelioma, NIPEC and HIPEC are not the same.
- HIPEC is given once during surgery using heated chemotherapy.
- NIPEC is given after surgery at normal body temperature, usually in multiple treatments through an implanted port.
In some cases, both options may be part of the same treatment plan. Your mesothelioma specialist can give you a better idea about how each treatment could help you.
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