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Debate 14A - Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?

Yes

from Section III - Ovarian Cancer

Published online by Cambridge University Press:  20 July 2023

Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
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Summary

Recurrence rates and mortality in women with advanced ovarian cancer remain high, despite progress in therapeutic strategies and surgical techniques in the last decades. Peritoneal dissemination is a distinctive feature in the natural history of the disease and forms a target for hyperthermic intraperitoneal chemotherapy (HIPEC), complementary to (near) complete cytoreductive surgery (CRS). The high intraperitoneal concentration of chemotherapy under hyperthermic conditions increases penetration into tumor deposits and potentiates the cytotoxic effect. A recent randomized controlled trial demonstrated its evident survival benefit in front-line in a selected patient population, without incurring additional toxicity. Whether this survival benefit applies to women undergoing primary CRS is currently investigated. Several unanswered questions – e.g. open versus closed procedure, patient selection, and integration with subsequent therapies – need more research, ultimately leading to a uniform protocol and adoption into routine care, with the aim of improving survival outcomes for women with advanced ovarian cancer.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

Jaaback, K, et al. Intraperitoneal chemotherapy for the initial management of primary epithelial ovarian cancer. Cochrane Database Syst Rev 2016;11:CD005340. https://doi.org/10.1002/14651858.cd005340.pub3Google Scholar
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González-Moreno, S, et al. Hyperthermic intraperitoneal chemotherapy: rationale and technique. World J Gastrointest Oncol 2010;2:6875.CrossRefGoogle ScholarPubMed
Huo, YR, et al. Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS) in ovarian cancer: a systematic review and meta-analysis. Eur J Surg Oncol 2015;41:15781589.CrossRefGoogle ScholarPubMed
van Driel, WJ, et al. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N Engl J Med 2018;378:13631364.CrossRefGoogle ScholarPubMed
Koole, SN, et al. Cost effectiveness of interval cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in stage iii ovarian cancer on the basis of a randomized phase iii trial. J Clin Oncol 2019;37:20412050.Google ScholarPubMed

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