Role of Intraperitoneal Therapy in the Initial Management of Ovarian Cancer

Armstrong, Deborah K.; Walker, Joan L.

doi:10.1200/jco.19.00671

Cited by 16 publications

(12 citation statements)

References 17 publications

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“…In GOG 252, 57% of patients had no gross residual disease and those patients experienced an OS benefit of 104.8 months in the IP carboplatin arm when compared to 98.8 months in the IV carboplatin arm with both arms receiving bevacizumab 6 . In GOG 114, patients with no gross residual disease who were treated with IP chemotherapy experienced a median OS of 83.8 months, while in GOG 172, OS was as high as 127.6 months in the IP arm 17‐19 . Furthermore, evidence suggests that women with germline or somatic BRCA mutations may have an improved response to IP chemotherapy when compared to IV chemotherapy since these tumors may be more vulnerable to the prolonged and high concentration of IP chemotherapy due to the inherent defects in homologous recombination within the tumors deficient of BRCA 20 .…”

Section: Discussionmentioning

confidence: 99%

“…6 In GOG 114, patients with no gross residual disease who were treated with IP chemotherapy experienced a median OS of 83.8 months, while in GOG 172, OS was as high as 127.6 months in the IP arm. [17][18][19] Furthermore, evidence suggests that women with germline or somatic BRCA mutations may have an improved response to IP chemotherapy when compared to IV chemotherapy since these tumors may be more vulnerable to the prolonged and high concentration of IP chemotherapy due to the inherent defects in homologous recombination within the tumors deficient of BRCA. 20 In line with previous studies, 21,22 the present data demonstrate that recurrences after IP chemotherapy were more likely to be retroperitoneal or extraperitoneal, whereas recurrences after IV chemotherapy were more likely to initially present in the abdomen or pelvis.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and toxicity of intraperitoneal chemotherapy as compared to intravenous chemotherapy in the treatment of patients with advanced ovarian cancer

Kim

Maganti

Bernardini

et al. 2021

Intl J Gynecology & Obste

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Objective To assess the efficacy and toxicity of intraperitoneal (IP) chemotherapy compared to intravenous (IV) chemotherapy. Methods Toxicity profiles, recurrence patterns, and long‐term survival outcomes of 271 women with Stage IIIC or IV high‐grade serous ovarian cancer (HGSC) treated with primary cytoreductive surgery followed by adjuvant IP or IV chemotherapy during 2001–2015 were reviewed. Results Women who received IP chemotherapy (n = 91) were more likely to have undergone aggressive and longer surgery with no residual disease compared to the IV arm (n = 180). Chemotherapy‐related toxicities were comparable between the two groups. Extraperitoneal recurrences were more common in the IP arm compared to the IV arm. Five‐year progression‐free survival was 19% versus 18% (P = 0.63) and overall survival was 73% versus 44% (P < 0.01) in the IP versus IV arms, respectively. After adjustment for significant clinicopathologic factors in a multivariable model, use of IP was no longer a statistically significant predictor of overall survival. Conclusion IP chemotherapy in advanced HGSC has not been widely adopted due to concerns about toxicity and inconvenience. Use of IP chemotherapy was associated with comparable safety profile and efficacy to IV chemotherapy in women with Stage IIIC/IV HGSC. Recurrences were more likely to be extraperitoneal with IP treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy and toxicity of intraperitoneal chemotherapy as compared to intravenous chemotherapy in the treatment of patients with advanced ovarian cancer

Kim

Maganti

Bernardini

et al. 2021

Intl J Gynecology & Obste

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“…The toxicities associated with SOC chemotherapy for ovarian cancer that often limit dosing and clinical benefit have encouraged the development of alternative therapies ( Ledermann, 2017 , Fujiwara et al, 2019 , Lee et al, 2019 , Armstrong and Walker, 2019 , Trimble et al, 2008 ). Results from this study using IP SPP given at the time of surgical debulking as a local drug-delivery depot of paclitaxel are encouraging.…”

Section: Discussionmentioning

confidence: 99%

Phase II study of intraperitoneal submicron particle paclitaxel (SPP) plus IV carboplatin and paclitaxel in patients with epithelial ovarian cancersurgery

Mullany

Miller

Robison

et al. 2020

Gynecologic Oncology Reports

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“…Его клинические эффекты были подтверждены несколькими клиническими испытаниями [22]. Из-за своей большой молекулярной массы и высокой растворимости в жирах паклитаксел медленно всасывается через лимфатическую систему после интраперитонеального введения, что приводит к высокой концентрации этого лекарственного средства в брюшной полости [23].…”

Section: неоадъювантная интраперитонеальная и системная химиотерапия ...unclassified

Gastric cancer: modern approaches and prospects of treatment for peritoneal carcinomatosis (literature review)

et al. 2022

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Gastric cancer (gc) is one of the most common cancers worldwide. The majority of newly diagnosed gastric cancer cases present with distant metastases. Peritoneal carcinomatosis (pc) is the most unfavorable type of progression of primary gc, which occurs in 14–43 % of patients. The purpose of the study was to highlight modern approaches to the treatment of gc with pc. Material and methods. We analyzed 136 publications available from pubmed, medline, cochrane library, and elibrary databases. The final analysis included 46 studies that met the specified parameters. Results. The modern approaches to the treatment of gc with peritoneal carcinomatosis were reviewed, namely: cytoreductive surgery (crs), combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (crs/hipec); neoadjuvant intraperitoneal/systemic chemotherapy (nips) and pressurized intraperitoneal aerosol chemotherapy (pipac). The results of large randomized trials and meta-analyses were analyzed. Benefits and limitations of these trials were assessed. Conclusion. The peritoneal cancer index (pci) and the level of cytoreduction are two key prognostic factors for increasing the median overall survival. By reducing tumor volume through cytoreductive surgery, it is possible to allow tumor cells to re-enter the proliferative phase of the cell cycle and make them more sensitive to antitumor agents. The hematoperitoneal barrier is the main reason that prevents the effective delivery of drugs from the systemic bloodstream to the abdominal cavity, which is why the effect of systemic chemotherapy on peritoneal metastases is extremely limited. Intraperitoneal chemotherapy offers a more effective and intensive regional therapy, creating a so-called «depot» of a chemotherapy drug, thereby prolonging the effect of the administered drugs. Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (crs + hipec) using the combination of surgical resection, cytotoxic chemotherapy, hyperthermic ablation of the tumor and hydrodynamic flushing, is a promising approach in the treatment of gc with peritoneal carcinomatosis.

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Role of Intraperitoneal Therapy in the Initial Management of Ovarian Cancer

Cited by 16 publications

References 17 publications

Efficacy and toxicity of intraperitoneal chemotherapy as compared to intravenous chemotherapy in the treatment of patients with advanced ovarian cancer

Efficacy and toxicity of intraperitoneal chemotherapy as compared to intravenous chemotherapy in the treatment of patients with advanced ovarian cancer

Phase II study of intraperitoneal submicron particle paclitaxel (SPP) plus IV carboplatin and paclitaxel in patients with epithelial ovarian cancersurgery

Gastric cancer: modern approaches and prospects of treatment for peritoneal carcinomatosis (literature review)

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