Hyperthermic intraperitoneal chemotherapy for ovarian cancer: The heat is on

Koole, Simone N.; Driel, Willemien J. van; Sonke, Gabe S.

doi:10.1002/cncr.32505

Cited by 29 publications

(24 citation statements)

References 49 publications

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“…A detailed discussion on this approach is outside the scope of this review. Interested readers may like to further explore through some recent reviews on this approach (184)(185)(186)(187)(188)(189)(190)(191)(192)(193)(194).…”

Section: Hyperthermia: a Chemosensitizermentioning

confidence: 99%

Integrating Loco-Regional Hyperthermia Into the Current Oncology Practice: SWOT and TOWS Analyses

et al. 2020

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Moderate hyperthermia at temperatures between 40 and 44 • C is a multifaceted therapeutic modality. It is a potent radiosensitizer, interacts favorably with a host of chemotherapeutic agents, and, in combination with radiotherapy, enforces immunomodulation akin to "in situ tumor vaccination." By sensitizing hypoxic tumor cells and inhibiting repair of radiotherapy-induced DNA damage, the properties of hyperthermia delivered together with photons might provide a tumor-selective therapeutic advantage analogous to high linear energy transfer (LET) neutrons, but with less normal tissue toxicity. Furthermore, the high LET attributes of hyperthermia thermoradiobiologically are likely to enhance low LET protons; thus, proton thermoradiotherapy would mimic 12 C ion therapy. Hyperthermia with radiotherapy and/or chemotherapy substantially improves therapeutic outcomes without enhancing normal tissue morbidities, yielding level I evidence reported in several randomized clinical trials, systematic reviews, and meta-analyses for various tumor sites. Technological advancements in hyperthermia delivery, advancements in hyperthermia treatment planning, online invasive and non-invasive MR-guided thermometry, and adherence to quality assurance guidelines have ensured safe and effective delivery of hyperthermia to the target region. Novel biological modeling permits integration of hyperthermia and radiotherapy treatment plans. Further, hyperthermia along with immune checkpoint inhibitors and DNA damage repair inhibitors could further augment the therapeutic efficacy resulting in synthetic lethality. Additionally, hyperthermia induced by magnetic nanoparticles coupled to selective payloads, namely, tumor-specific radiotheranostics (for both tumor imaging and radionuclide therapy), chemotherapeutic drugs, immunotherapeutic agents, and gene silencing, could provide a comprehensive tumor-specific theranostic modality akin to "magic (nano)bullets." To get a realistic overview of the strength (S), weakness (W), opportunities (O), and threats (T) of hyperthermia, a SWOT analysis has been undertaken. Additionally, a TOWS analysis Datta et al.Hyperthermia: SWOT and TOWS Analyses categorizes future strategies to facilitate further integration of hyperthermia with the current treatment modalities. These could gainfully accomplish a safe, versatile, and cost-effective enhancement of the existing therapeutic armamentarium to improve outcomes in clinical oncology.

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Section: Hyperthermia: a Chemosensitizermentioning

confidence: 99%

Integrating Loco-Regional Hyperthermia Into the Current Oncology Practice: SWOT and TOWS Analyses

et al. 2020

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“…The median follow-up was 63.5 months (CI95% 43.5-83.5). The median overall (OS) and disease-free (DFS) survival for the entire group was 52 (CI95% 43-62) and 20 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) months, respectively. Among the perioperative factors identified at Cox analysis and at univariate analysis for OS, only the completeness of cytoreduction (CC) score (p < 0.0001), pancreatic resection (p = 0.06) and number of resections (p = 0.08) remained significant at multivariate analysis (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…In our experience, the upfront and IDS subgroup of patients showed significantly higher OS rates (56% and 57%, respectively), but the low number of cases limits the statistical power. The OVHIPEC-2 trial has been designed and will hopefully answer whether HIPEC during upfront CRS is beneficial [25].…”

Section: Discussionmentioning

confidence: 99%

Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Epithelial Ovarian Cancer: A 20-Year Single-Center Experience

Carboni

Federici

Sperduti

et al. 2021

Cancers

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Despite improvement in treatments, the peritoneum remains the primary site of relapse in most ovarian cancer cases. Patients who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from epithelial ovarian cancer were reviewed. Kaplan–Meier curves and multivariate Cox analyses were used to identify survival rates and prognostic factors. This study included 158 patients. The procedure was mostly performed for recurrent disease (46.8%) and high-grade serous carcinoma (58.2%). The median peritoneal cancer index was 14, and complete cytoreduction was obtained in 87.9% of cases. Grade IV morbidity occurred in 15.2% of patients, mostly requiring surgical reoperation, and one patient (0.6%) died within 90 days. The median follow-up was 63.5 months. The Kaplan–Meier 5-year overall survival (OS) and disease-free survival (DFS) rates were 42.1% and 24.3%, respectively. Multiple regression logistic analyses demonstrated that the completeness of cytoreduction (CC) score (p ≤ 0.0001), pancreatic resection (p ≤ 0.0001) and number of resections (p = 0.001) were significant factors influencing OS; whereas the CC score (p ≤ 0.0001) and diaphragmatic procedures (p = 0.01) were significant for DFS. The addition of hyperthermic intraperitoneal chemotherapy to standard multimodality therapy may improve outcomes in both primary and recurrent epithelial ovarian cancer without impairing early postoperative results, but the exact timing has not yet been established. Prospective randomized studies will clarify the role and indications of this approach.

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“…OVHIPEC-2 (NCT03772028) has been designed and will hopefully answer whether HIPEC during upfront cytoreduction is also beneficial [37]. Further questions regarding the most appropriate chemotherapeutic agent, dosing, dwell time, and temperature also exist.…”

Section: Applications In Primary Ovarian Cancermentioning

confidence: 99%

Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer

et al. 2020

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Hyperthermic intraperitoneal chemotherapy (HIPEC) in conjunction with cytoreductive surgery (CRS) holds promise as an adjunctive treatment strategy in malignancies affecting the peritoneal surface, effectively targeting remaining microscopic residual tumor. HIPEC increases concentrations of chemotherapy directly within the peritoneal cavity compared with the intravenous route and reduces the systemic side effects associated with prolonged adjuvant intraperitoneal exposure. Furthermore, hyperthermia increases tissue penetration and is synergistic with the therapeutic chemotherapy agents used. In ovarian cancer, evidence is building for its use in both primary and recurrent scenarios. In this review, we examine the history of HIPEC, the techniques used, and the available data guiding its use in primary and recurrent ovarian cancer.

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Hyperthermic intraperitoneal chemotherapy for ovarian cancer: The heat is on

Cited by 29 publications

References 49 publications

Integrating Loco-Regional Hyperthermia Into the Current Oncology Practice: SWOT and TOWS Analyses

Integrating Loco-Regional Hyperthermia Into the Current Oncology Practice: SWOT and TOWS Analyses

Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Epithelial Ovarian Cancer: A 20-Year Single-Center Experience

Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer

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