The addition of collagenase to BromAc ® for the management of inoperable pseudomyxoma peritonei – in vitro results
Year: 2025
Type: article
Abstract: Objectives Pseudomyxoma peritonei (PMP) is a rare peritoneal malignancy. BromAc ® is a novel therapeutic agent which has been developed to dissolve and facilitate the drainage of mucin as a palliative treatment for PMP; however, its effect is significantly reduced in patients with hard mucin. This study aimed to assess whether combining collagenase or cysteamine with BromAc ® would be more effective in dissolving hard mucin. Methods This preclinical human in vitro study examined the effect of adding collagenase to BromAc ® on hard mucin samples when incubated at 37 °C over 24 h. The effect of cysteamine alone and in combination with collagenase and BromAc ® was also examined as a supplementary arm of this study. Five experiments were conducted with appropriate controls. Human hard mucin samples were sliced into equal fractions using a sterile surgical scalpel, weighed and noted. The leftover solid mucin was weighed at 0, 1, 3, 5, and 24 h post-treatment. Results At 24 h post-treatment, all combinations with collagenase demonstrated almost 100 % dissolution of hard mucin. At 3 and 5 h post-treatment, only BromAc ® with collagenase at 250 μg/mL was found to be superior to BromAc ® alone. Combinations with cysteamine were not found to be effective. Conclusions This study provides promising evidence of the efficacy and synergistic effect of combining BromAc ® with collagenase to dissolve hard mucin. Further preclinical and clinical research should be undertaken to assess its safety and efficacy in the clinical setting.
Source: Pleura and Peritoneum
DOI: 10.1515/pp-2025-0026
Authors: Carissa Vici, Mathew Eapen, Pooja Narang, David L. Morris
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,187
OpenAlex ID: W4415683903