It's time to warm up to hyperthermic intraperitoneal chemotherapy for patients with ovarian cancer Journal Article

Authors: Zivanovic, O.; Chi, D. S.; Filippova, O.; Randall, L. M.; Bristow, R. E.; O'Cearbhaill, R. E.
Article Title: It's time to warm up to hyperthermic intraperitoneal chemotherapy for patients with ovarian cancer
Abstract: The peritoneal spread of ovarian cancer makes it a potential target for hyperthermic intraperitoneal chemotherapy (HIPEC). Intraperitoneal delivery exposes the tumor to concentrations of cytotoxic drugs much greater than with intravenous delivery, and in vitro studies have also shown that combining hyperthermia and platinum leads to an additive cytotoxic effect. Pharmacokinetic analyses have confirmed very high concentrations of cytotoxic drugs in the peritoneal cavity, with minimal systemic exposure and toxicity. The majority of historical data evaluating HIPEC in ovarian cancer are based on retrospective research, which included heterogeneous groups of patients and drugs used for HIPEC. Recent publications on the findings of prospective studies, including the first randomized trial in which the only difference in intervention was the addition of HIPEC with cisplatin to interval debulking surgery in stage III patients, have shown a benefit in favor of HIPEC. Yet, a recent prospective study from Korea did not find a benefit. Opponents of HIPEC have cited higher rates of complications with this approach, yet most of the serious adverse events observed are likely related to the surgery itself, and are comparable to the rates reported in studies evaluating cytoreductive surgery without HIPEC. Findings from a recent randomized controlled trial showed no delays in initiation or completion of postoperative chemotherapy in patients treated with HIPEC. A growing body of evidence is indicating that it might be time to seriously consider HIPEC as a complementary treatment at the time of cytoreductive surgery for patients with advanced-stage ovarian cancer in the setting of an experienced center. Yet, more research is needed to identify the population of patients who gain the most benefit from this therapy. © 2018 Elsevier Inc.
Keywords: cancer surgery; review; postoperative period; cancer staging; antineoplastic agent; prospective study; ovarian cancer; cytoreductive surgery; ovary cancer; morbidity; cancer research; cancer mortality; hyperthermia; debulking surgery; pharmacokinetic parameters; phase 2 clinical trial (topic); phase 1 clinical trial (topic); hyperthermic intraperitoneal chemotherapy; human; female; priority journal; hipec; obstetric delivery; warm up
Journal Title: Gynecologic Oncology
Volume: 151
Issue: 3
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2018-12-01
Start Page: 555
End Page: 561
Language: English
DOI: 10.1016/j.ygyno.2018.09.007
PROVIDER: scopus
PUBMED: 30249527
Notes: Gynecol. Oncol. -- Export Date: 2 January 2019 -- Review -- CODEN: GYNOA C2 - 30249527 -- Source: Scopus
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MSK Authors
  1. Dennis S Chi
    495 Chi
  2. Oliver Zivanovic
    117 Zivanovic