HIPEC: Turning up the heat on ovarian cancer

Farrell, Rhonda; Burling, Michael

doi:10.1111/ajo.13297

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…The OVHIPEC-2 study, an international multicenter RCT of HIPEC at the time of up-front surgery for stage III ovarian cancer was then started. The primary objective of the study was to evaluate the effect of HIPEC on the OS in patients with FIGO stage III epithelial ovarian cancers who were treated with primary cytoreductive surgery resulting in no residual disease, or residual disease up to a maximum dimension of 2.5 mm [ 18 , 32 , 33 ]. However, there were criticisms of OVHIPEC questioning the use of HIPEC.…”

Section: Resultsmentioning

confidence: 99%

“…The 3-year overall survival rate was 60.3% (95% CI: 55.3–65.0%) for patients undergoing primary cytorecductive surgery (PCS) plus HIPEC and 49.5% (95% CI: 41.0–57.4%) for patients undergoing PCS alone (weighted HR: 0.64; 95% CI: 0.50–0.82; p < 0.001). Complete PCS with HIPEC was associated with the best survival outcomes, with a median OS of 53.9 months and a 3-year OS rate of 65.9% [ 18 , 19 ].…”

Section: Therapeutic Effects Of Hipec In Epithelial Ovarian Cancersmentioning

confidence: 99%

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Hyperthermic Intraperitoneal Chemotherapy (HIPEC): An Overview of the Molecular and Cellular Mechanisms of Actions and Effects on Epithelial Ovarian Cancers

Lim

Han

Seow

et al. 2022

IJMS

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Most patients with epithelial ovarian cancers (EOCs) are at advanced stages (stage III–IV), for which the recurrence rate is high and the 5-year survival rate is low. The most effective treatment for advanced diseases involves a debulking surgery followed by adjuvant intravenous chemotherapy with carboplatin and paclitaxel. Nevertheless, systemic treatment with intravenous chemotherapeutic agents for peritoneal metastasis appears to be less effective due to the poor blood supply to the peritoneal surface with low drug penetration into tumor nodules. Based on this reason, hyperthermic intraperitoneal chemotherapy (HIPEC) emerges as a new therapeutic alternative. By convection and diffusion, the hyperthermic chemotherapeutic agents can directly contact intraperitoneal tumors and produce cytotoxicity. In a two-compartment model, the peritoneal–plasma barrier blocks the leakage of chemotherapeutic agents from peritoneal cavity and tumor tissues to local vessels, thus maintaining a higher concentration of chemotherapeutic agents within the tumor tissues to facilitate tumor apoptosis and a lower concentration of chemotherapeutic agents within the local vessels to decrease systemic toxicity. In this review, we discuss the molecular and cellular mechanisms of HIPEC actions and the effects on EOCs, including the progression-free survival (PFS), disease-free survival (DFS) and overall survival (OS). For primary advanced ovarian cancers, more studies are agreeing that patients undergoing HIPEC have better surgical and clinical (PFS; OS) outcomes than those not, although one study reported no differences in the PFS and OS. For recurrent ovarian cancers, studies have revealed better DFS and OS in patients undergoing HIPEC than those in patients not undergoing HIPEC, although one study reported no differences in the PFS. HIPEC appears comparable to traditional intravenous chemotherapy in treating advanced EOCs. Overall, HIPEC has demonstrated some therapeutic benefits in many randomized phase III trials when combined with the standard cytoreductive surgeries for advanced EOCs. Nevertheless, many unknown aspects of HIPEC, including detailed mechanisms of actions, along with the effectiveness and safety for the treatment of EOCs, warrant further investigation.

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Section: Resultsmentioning

confidence: 99%

Section: Therapeutic Effects Of Hipec In Epithelial Ovarian Cancersmentioning

confidence: 99%

Hyperthermic Intraperitoneal Chemotherapy (HIPEC): An Overview of the Molecular and Cellular Mechanisms of Actions and Effects on Epithelial Ovarian Cancers

Lim

Han

Seow

et al. 2022

IJMS

View full text Add to dashboard Cite

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“…What is important is that the administration of the drug takes place immediately after cytoreductive surgery. The advantage of HIPEC therapy is 10-20 times higher drug concentration delivered directly to cancer cells, compared to intravenous chemotherapy [109]. The results of multiple studies show that patients who received HIPEC therapy showed a significant increase in overall survival time, as well as an increase in progression-free survival [109].…”

Section: Combination Therapy With Cisplatin and Hyperthermiamentioning

confidence: 99%

Cisplatin in Ovarian Cancer Treatment—Known Limitations in Therapy Force New Solutions

Zoń

Bednarek

2023

IJMS

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Cisplatin is one of the most commonly used anticancer drugs worldwide. It is mainly used in the treatment of ovarian cancer, but also used in testicular, bladder and lung cancers. The significant advantage of this drug is the multidirectional mechanism of its anticancer action, with the most important direction being damaging the DNA of cancer cells. Unfortunately, cisplatin displays a number of serious disadvantages, including toxicity to the most important organs, such as kidneys, heart, liver and inner ear. Moreover, a significant problem among patients with ovarian cancer, treated with cisplatin, is the development of numerous resistance mechanisms during therapy, including changes in the processes of cellular drug import and export, changes in the DNA damage repair mechanisms, as well as numerous changes in the processes of apoptosis and autophagy. Due to all of the mentioned problems, strategies to increase the effectiveness of cisplatin in the treatment of ovarian cancer are intensively sought. The most important strategy includes the development of less toxic cisplatin analogs. Another important direction is combination therapy, involving the simultaneous use of cisplatin with different anticancer drugs, substances derived from plants, temperature or radiotherapy. Many years of observations accompanying the presence of cisplatin in the therapy made it possible to provide a series of verifiable, statistically significant data, but also to show how, over time, with the new information and scientific discoveries, it is possible to describe and understand the therapeutic problems observed in practice, such as the acquisition of drug resistance by tumor cells or induction of changes in the tumor microenvironment. According to the authors, confronting what we knew so far with what new trends offer has a profound meaning. This paper presents information on the history of cisplatin and describes the molecular mechanisms of its action and the development of resistance by cancer cells. In addition, our goal was to highlight a number of therapeutic strategies to increase the effectiveness of cisplatin in the treatment of ovarian cancer, as well as to identify methods to eliminate problems associated with the use of cisplatin.

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“…A French multicenter randomized trial (CHIPOR; ClinicalTrials.gov identifier: NCT01376752) was initiated in 2011 and compares CRS alone with CRS plus HIPEC in patients with recurrent ovarian cancer. Interestingly, the recently initiated Australian HyNOVA (Hyperthermic versus Normothermic intraperitoneal chemotherapy following interval cytoreductive surgery for stage III epithelial OVArian cancer) will compare interval debulking and chemoperfusion with cisplatin (100 mg/m 2 , 90 min) at two different temperatures: 42.0 • C and 37.0 • C [72]. Currently, therefore, the available evidence supports the use of HIPEC in association with interval CRS in stage III EOC.…”

Section: Ovarian Cancermentioning

confidence: 99%

Hyperthermic Intraperitoneal Chemotherapy: A Critical Review

Ceelen

Demuytere

Hingh

2021

Cancers

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With increasing awareness amongst physicians and improved radiological imaging techniques, the peritoneal cavity is increasingly recognized as an important metastatic site in various malignancies. Prognosis of these patients is usually poor as traditional treatment including surgical resection or systemic treatment is relatively ineffective. Intraperitoneal delivery of chemotherapeutic agents is thought to be an attractive alternative as this results in high tumor tissue concentrations with limited systemic exposure. The addition of hyperthermia aims to potentiate the anti-tumor effects of chemotherapy, resulting in the concept of heated intraperitoneal chemotherapy (HIPEC) for the treatment of peritoneal metastases as it was developed about 3 decades ago. With increasing experience, HIPEC has become a safe and accepted treatment offered in many centers around the world. However, standardization of the technique has been poor and results from clinical trials have been equivocal. As a result, the true value of HIPEC in the treatment of peritoneal metastases remains a matter of debate. The current review aims to provide a critical overview of the theoretical concept and preclinical and clinical study results, to outline areas of persisting uncertainty, and to propose a framework to better define the role of HIPEC in the treatment of peritoneal malignancies.

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HIPEC: Turning up the heat on ovarian cancer

Cited by 6 publications

References 20 publications

Hyperthermic Intraperitoneal Chemotherapy (HIPEC): An Overview of the Molecular and Cellular Mechanisms of Actions and Effects on Epithelial Ovarian Cancers

Hyperthermic Intraperitoneal Chemotherapy (HIPEC): An Overview of the Molecular and Cellular Mechanisms of Actions and Effects on Epithelial Ovarian Cancers

Cisplatin in Ovarian Cancer Treatment—Known Limitations in Therapy Force New Solutions

Hyperthermic Intraperitoneal Chemotherapy: A Critical Review

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