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Open Access 29-01-2025 | Cytostatic Therapy | Invited Review Article

Intraperitoneal chemotherapy is now back for ovarian cancer

Authors: Keiichi Fujiwara, Shoji Nagao, David Tan, Kosei Hasegawa

Published in: International Journal of Clinical Oncology

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Abstract

The Intraperitoneal Carboplatin for Ovarian Cancer (iPocc) trial demonstrated that intraperitoneal (IP) administration of carboplatin is more effective than intravenous (IV) administration for advanced ovarian cancer, especially in cases with large residual tumors, challenging previous assumptions that IP chemotherapy is only beneficial for small residual tumors. Additionally, the iPocc trial showed that IP chemotherapy has a comparable safety profile to IV chemotherapy, with the exception of port-related toxicities. This review summarizes the principles, development, and significance of IP chemotherapy and discusses its future potential in light of recent studies. Notably, the iPocc trial, conducted under Japan’s new clinical trial regulations, achieving regulatory approval based on investigator-initiated results. The iPocc regimen offers a viable treatment option for patients with advanced ovarian cancer (stages II–IV). However, bevacizumab is recommended for later-line treatments rather than combining it with IP chemotherapy until further trials support such combinations. Future studies are needed to identify biomarkers that predict response to the iPocc regimen. The trial’s success underscores the dedication of patients and families who contributed to this groundbreaking research.
Literature
1.
go back to reference Nagao S, Fujiwara K, Yamamoto K et al (2023) Intraperitoneal carboplatin for ovarian cancer—a phase 2/3 trial. NEJM Evid 2(5):EVIDoa2200225CrossRefPubMed Nagao S, Fujiwara K, Yamamoto K et al (2023) Intraperitoneal carboplatin for ovarian cancer—a phase 2/3 trial. NEJM Evid 2(5):EVIDoa2200225CrossRefPubMed
2.
go back to reference Fujiwara K, Armstrong D, Morgan M et al (2007) Principles and practice of intraperitoneal chemotherapy for ovarian cancer. Int J Gynecol Cancer 17(1):1–20CrossRefPubMed Fujiwara K, Armstrong D, Morgan M et al (2007) Principles and practice of intraperitoneal chemotherapy for ovarian cancer. Int J Gynecol Cancer 17(1):1–20CrossRefPubMed
3.
go back to reference de Bree E, Michelakis D, Stamatiou D et al (2017) Pharmacological principles of intraperitoneal and bidirectional chemotherapy. Pleura Peritoneum 2(2):47–62CrossRefPubMedPubMedCentral de Bree E, Michelakis D, Stamatiou D et al (2017) Pharmacological principles of intraperitoneal and bidirectional chemotherapy. Pleura Peritoneum 2(2):47–62CrossRefPubMedPubMedCentral
4.
go back to reference Miyagi Y, Fujiwara K, Kigawa J et al (2005) Intraperitoneal carboplatin infusion may be a pharmacologically more reasonable route than intravenous administration as a systemic chemotherapy. A comparative pharmacokinetic analysis of platinum using a new mathematical model after intraperitoneal vs. intravenous infusion of carboplatin—a Sankai Gynecology Study Group (SGSG) study. Gynecol Oncol 99(3):591–596CrossRefPubMed Miyagi Y, Fujiwara K, Kigawa J et al (2005) Intraperitoneal carboplatin infusion may be a pharmacologically more reasonable route than intravenous administration as a systemic chemotherapy. A comparative pharmacokinetic analysis of platinum using a new mathematical model after intraperitoneal vs. intravenous infusion of carboplatin—a Sankai Gynecology Study Group (SGSG) study. Gynecol Oncol 99(3):591–596CrossRefPubMed
5.
go back to reference Armstrong DK, Bundy B, Wenzel L et al (2006) Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med 354(1):34–43CrossRefPubMed Armstrong DK, Bundy B, Wenzel L et al (2006) Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med 354(1):34–43CrossRefPubMed
6.
go back to reference Walker JL, Armstrong DK, Huang HQ et al (2006) Intraperitoneal catheter outcomes in a phase III trial of intravenous versus intraperitoneal chemotherapy in optimal stage III ovarian and primary peritoneal cancer: a Gynecologic Oncology Group Study. Gynecol Oncol 100(1):27–32CrossRefPubMed Walker JL, Armstrong DK, Huang HQ et al (2006) Intraperitoneal catheter outcomes in a phase III trial of intravenous versus intraperitoneal chemotherapy in optimal stage III ovarian and primary peritoneal cancer: a Gynecologic Oncology Group Study. Gynecol Oncol 100(1):27–32CrossRefPubMed
8.
go back to reference Naumann RW, Sukumvanich P, Edwards RP (2009) Practice patterns of intraperitoneal chemotherapy in women with ovarian cancer. Gynecol Oncol 114(1):37–41CrossRefPubMed Naumann RW, Sukumvanich P, Edwards RP (2009) Practice patterns of intraperitoneal chemotherapy in women with ovarian cancer. Gynecol Oncol 114(1):37–41CrossRefPubMed
10.
go back to reference Provencher DM, Gallagher CJ, Parulekar WR et al (2018) OV21/PETROC: a randomized Gynecologic Cancer Intergroup phase II study of intraperitoneal versus intravenous chemotherapy following neoadjuvant chemotherapy and optimal debulking surgery in epithelial ovarian cancer. Ann Oncol 29(2):431–438CrossRefPubMed Provencher DM, Gallagher CJ, Parulekar WR et al (2018) OV21/PETROC: a randomized Gynecologic Cancer Intergroup phase II study of intraperitoneal versus intravenous chemotherapy following neoadjuvant chemotherapy and optimal debulking surgery in epithelial ovarian cancer. Ann Oncol 29(2):431–438CrossRefPubMed
11.
go back to reference Fujiwara K, Aotani E, Hamano T et al (2011) A randomized Phase II/III trial of 3 weekly intraperitoneal versus intravenous carboplatin in combination with intravenous weekly dose-dense paclitaxel for newly diagnosed ovarian, fallopian tube and primary peritoneal cancer. Jpn J Clin Oncol 41(2):278–282CrossRefPubMed Fujiwara K, Aotani E, Hamano T et al (2011) A randomized Phase II/III trial of 3 weekly intraperitoneal versus intravenous carboplatin in combination with intravenous weekly dose-dense paclitaxel for newly diagnosed ovarian, fallopian tube and primary peritoneal cancer. Jpn J Clin Oncol 41(2):278–282CrossRefPubMed
12.
go back to reference Tan DSP, Tan TZ, Ye J et al (2022) A gene expression signature to predict benefit from intraperitoneal (IP) carboplatin chemotherapy in ovarian carcinoma (OC): translational research study from the IP therapy for OC with Carboplatin (iPocc) phase 2/3 trial ESMO. Ann Oncol 34:S525CrossRef Tan DSP, Tan TZ, Ye J et al (2022) A gene expression signature to predict benefit from intraperitoneal (IP) carboplatin chemotherapy in ovarian carcinoma (OC): translational research study from the IP therapy for OC with Carboplatin (iPocc) phase 2/3 trial ESMO. Ann Oncol 34:S525CrossRef
13.
go back to reference Zunino B, Rubio-Patino C, Villa E et al (2016) Hyperthermic intraperitoneal chemotherapy leads to an anticancer immune response via exposure of cell surface heat shock protein 90. Oncogene 35(2):261–268CrossRefPubMed Zunino B, Rubio-Patino C, Villa E et al (2016) Hyperthermic intraperitoneal chemotherapy leads to an anticancer immune response via exposure of cell surface heat shock protein 90. Oncogene 35(2):261–268CrossRefPubMed
14.
go back to reference Ogasawara A, Matsushita H, Tan TZ et al (2023) Analyses of tumor microenvironment affecting on the survival in patients with ovarian cancer receiving intraperitoneal chemotherapy: translational research from the phase 3 trial of IntraPeritoneal therapy for Ovarian Cancer with Carboplatin (TRiPocc). J Clin Oncol 41:abst5555CrossRef Ogasawara A, Matsushita H, Tan TZ et al (2023) Analyses of tumor microenvironment affecting on the survival in patients with ovarian cancer receiving intraperitoneal chemotherapy: translational research from the phase 3 trial of IntraPeritoneal therapy for Ovarian Cancer with Carboplatin (TRiPocc). J Clin Oncol 41:abst5555CrossRef
15.
go back to reference van Driel WJ, Koole SN, Sikorska K et al (2018) Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N Engl J Med 378(3):230–40CrossRefPubMed van Driel WJ, Koole SN, Sikorska K et al (2018) Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N Engl J Med 378(3):230–40CrossRefPubMed
16.
go back to reference Schwameis R, Chiva L, Harter P (2022) There is no role for hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer. Int J Gynecol Cancer 32(4):578CrossRefPubMed Schwameis R, Chiva L, Harter P (2022) There is no role for hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer. Int J Gynecol Cancer 32(4):578CrossRefPubMed
Metadata
Title
Intraperitoneal chemotherapy is now back for ovarian cancer
Authors
Keiichi Fujiwara
Shoji Nagao
David Tan
Kosei Hasegawa
Publication date
29-01-2025
Publisher
Springer Nature Singapore
Published in
International Journal of Clinical Oncology
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-025-02700-w

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