Ovarian cancer is the fourth leading cause of cancer death among women in the United States. First-line chemotherapy offered to patients with ovarian cancer generally consists of an intravenous (IV) platinum plus taxane regimen and has remained virtually unchanged for the past 10 years. A number of recently completed phase III randomized trials in the United States have reported improved progression-free survival (PFS) and/or overall survival (OS) with the intraperitoneal (IP) administration of cisplatin. The purpose of this study was to pool the published data to perform a meta-analysis of randomized trials of IP cisplatin in the initial chemotherapy treatment of ovarian cancer patients. This study was initiated to obtain a more valid estimate of the therapeutic impact of IP treatment for these patients. A search strategy was initiated that searched published findings of randomized trials of IP cisplatin therapy from multiple sources from January 1990 through January 2006. Six randomized trials of 1716 ovarian cancer patients were identified and included in this analysis. The pooled hazard ratio (HR) for PFS of IP cisplatin as compared to IV treatment regimens is 0.792 (95% CI: 0.688-0.912, P= 0.001), and the pooled HR for OS is 0.799 (95% CI: 0.702-0.910, P= 0.0007). These findings strongly support the incorporation of an IP cisplatin regimen to improve survival in the front-line treatment of stage III, optimally debulked ovarian cancer.

Methods: 12 patients (8 men, 4 women) with a median age of 64.5 years [range 44-83] suffering from both liver cirrhosis B7-B9 and unresectable nonmetastatic HCC were treated once or twice with Y-90 resin microspheres in our hospital in the years 2013-2017. In most patients alcohol abuse was the cause of liver cirrhosis. TACE was considered not to be effective in these patients. Our exclusion criteria for selective internal radiotherapy (SIRT) were either serum bilirubin >2.4 mg%, infiltration of the portal vein by tumor, portal vein thrombosis, extrahepatic metastasis, significant ascites, renal insufficiency, concurrent infection, uncontrolled bleeding or significant encephalopathy. Patients with bilobar HCC were scheduled for 2 separate unilobar SIRT sessions (1 right-sided, 1 left-sided, 4-6 weeks apart). Results: All patients adhered well to therapy and follow-up. Y-90 resin microspheres were well tolerated by the patients. In 2 patients transient flares of AST and/or ALT and/or bilirubin were noted. Epigastric discomfort for 1-2 days was reported by 5 patients. 10 patients died due to progressive disease, 2 patients are still alive. At 3 months after 1st SIRT the disease control rate was 50%. A median overall survival of 10.0 [range 4-16] months as calculated from 1st unilobar application of Y-90 microspheres was observed at this interim analysis; mean overall survival (after SIRT) amounts now to 9.3 þ 3.7 months (11.8 months for B7 and 7.5 months for B9 patients). Due to angiographic evaluation and ordering of Y-90 microspheres from overseas 4-6 weeks (without specific treatment) passed by between decision making and the first SIRT. Conclusion: SIRT therapy is safe in patients with unresectable nonmetastatic HCC and liver cirrhosis Child Pugh B7-9, as the chosen exclusion criteria are respected. Overall survival of our patients is better than the one reported for sorafenib treatment in HCCpatients with liver cirrhosis B7-9 of the GIDEON trial. Thus, SIRT with Y-90 resin microspheres should be considered for patients with unresectable nonmetastatic HCC and liver cirrhosis B7-9, if our exclusion criteria are observed. P À 098 Treatment patterns and costs of care for patients diagnosed with hepatocellular carcinoma (HCC) in the United States (U.S.

The 21-gene Breast Cancer Test (Oncotype DX®) is a validated diagnostic test that predicts the likelihood of adjuvant chemotherapy benefit and breast cancer recurrence in selected patients with early-stage breast cancer. A previous cost-effectiveness analysis of this test versus standard French clinical practice was published in 2012. Since then, docetaxel is no longer reimbursed on top of the diagnosis related groups (DRGs). The objective of this study was to update the costeffectiveness analysis considering this change. MethOds: The cost-effectiveness analysis was conducted using a Markov model including three health states (survival without recurrence, metastatic recurrence at ten years and death). Previous cost analyses were updated in order to assess the current overall costs of chemotherapy in public and private hospitals, considering that doxetaxel is not anymore reimbursed on top of DRGs. Unit costs were updated to 2015 values and other model parameters were collected from published literature. This study was conducted from the societal perspective. Deterministic sensitivity analyses were conducted to identify key drivers of the results. Results: Chemotherapy costs (standard deviation) per patient were estimated at € 10,917 from the societal perspectivein public hospitals. The incremental number of life years gained over 30 years was 0.15; the incremental number of QALYs gained was 0.14. Using the test was found to be costeffective versus usual care with a cost per QALY ratio of € 3,453 in public hospitals (€ 4,147 in private) from public perspective and a dominant strategy with a net costsaving per patient of € 658 in public hospitals (€ 449 in private) when considering costs of absenteeism. cOnclusiOns: While the cost of chemotherapy decreased considerably after the inclusion of docetaxel in the DRGs, the use of the 21-gene test is still cost-effective compared to usual care in French public and private hospitals from a societal perspective.

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