Safety of BromAc® with Mitomycin C during hyperthermic intraperitoneal chemotherapy (HIPEC): a preclinical study
Year: 2025
Type: article
Abstract: Peritoneal cancer patients are often treated with hyperthermic intraperitoneal chemotherapy (HIPEC).BromAc ® , a mixture of bromelain and acetylcysteine, has demonstrated anticancer properties with chemotherapeutic agents.Although bromelain and acetylcysteine have anti-inflammatory, anti-coagulant and wound healing properties, their effect with Mitomycin C is unknown in HIPEC.Hence, we investigated their safety using a rat model.Sixteen Wistar rats were divided into 4 groups (N=4).Controls received saline, whilst the others received BromAc ® , Mitomycin C (MMC) or BromAc ® +MMC.Three doses were given at 30-minute intervals.Animal weights were monitored for 7 days before euthanasia.Peritoneal fluid and blood samples were collected for pharmacokinetic analysis.Colon anastomosis healing was evaluated with burst pressure and collagen density assessment.Internal organ histology and coagulation factor X were performed in plasma with an enzyme-linked immune assay.All rats were healthy, with similar weight fluctuation patterns, although the MMC-treated rats, with or without BromAc ® , showed higher weight loss during the first 4 days.Whilst the burst pressure was similar in all groups, the BromAc ® group showed a slightly higher value.Collagen densities were similar in all groups.The results showed that the histology of vital organs of the treated and controls were similar.BromAc ® concentration in peritoneal fluids increased over 90 min with a higher increase when given with MMC.BromAc ® or the combination did not affect coagulation Factor X.In conclusion, general well-being, wound healing, organ histology, pharmacokinetics and coagulation factor evaluations indicated that BromAc ® with or without MMC was safe during HIPEC.
DOI: 10.62347/hqjh9945
Author: Ahmed H Mekkawy
Institutions: UNSW Sydney, St George Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4408951326