Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Current Treatment Options in Oncology
Published in: Current Treatment Options in Oncology 1/2014

01-03-2014 | Gynecologic Cancers (RJ Morgan, Section Editor)

Intraperitoneal Chemotherapy from Armstrong to HIPEC: Challenges and Promise

Authors: Ramez N. Eskander, MD, James Cripe, MD, Robert E. Bristow, MD

Published in: Current Treatment Options in Oncology | Issue 1/2014

Login to get access

Opinion

The treatment of advanced stage ovarian, primary peritoneal and fallopian tube cancer represents a therapeutic challenge as evidenced by the 70 %–80 % recurrence rate. Our understanding of the synergy between surgical cytoreduction and effective systemic chemotherapy continues to evolve, with research supporting maximal cytoreductive effort followed by intraperitoneal chemotherapy. Specifically, analysis of phase III clinical trials has shown a median survival of 110 months in those treated with intraperitoneal chemotherapy, when surgery results in no visible residual disease. Additionally, incorporation of hyperthermic intraperitoneal chemotherapy at the time of surgical resection has gained attention as an alternate therapeutic option, in an attempt to obviate toxicities encountered with repetitive cycles of intraperitoneal chemotherapy. Currently, surgical cytoreduction in the hands of an experienced gynecologic oncologist, followed by intraperitoneal chemotherapy is thought to portend the greatest survival benefit in patients with advanced stage ovarian cancer spectrum cancers. Additional investigation regarding the oncologic outcomes and morbidity of hyperthermic intraperitoneal chemotherapy is warranted.
Literature
1.
2.
3.
Bookman M. Trials with impact on clinical management: first line. Int J Gynecol Cancer. 2009;19 Suppl 2:S55–62.PubMedCrossRef
4.
5.
Winter III WE, Maxwell GL, Tian C, Carlson JW, Ozols RF, Rose PG, et al. Prognostic factors for stage III epithelial ovarian cancer: a Gynecologic Oncology Group Study. J Clin Oncol. 2007;25:3621–7.PubMedCrossRef
6.
Helm CW, Bristow RE, Kusamura S, Baratti D, Deraco M. Hyperthermic intraperitoneal chemotherapy with and without cytoreductive surgery for epithelial ovarian cancer. J Surg Oncol. 2008;98:283–90.PubMedCrossRef
7.
Tentes AA, Kakolyris S, Kyziridis D, Karamveri C. Cytoreductive surgery combined with hyperthermic intraperitoneal intraoperative chemotherapy in the treatment of advanced epithelial ovarian cancer. J Oncol. 2012;2012:358341
8.
Rossi CR, Foletto M, Mocellin S, Pilati P, De SM, Deraco M, et al. Hyperthermic intraoperative intraperitoneal chemotherapy with cisplatin and doxorubicin in patients who undergo cytoreductive surgery for peritoneal carcinomatosis and sarcomatosis: phase I study. Cancer. 2002;94:492–9.PubMedCrossRef
9.
Markman M, Rowinsky E, Hakes T, Reichman B, Jones W, Lewis JL Jr, et al. Intraperitoneal administration of Taxol in the management of ovarian cancer. J Natl Cancer Inst Monogr. 1993:103–6.
10.
Markman M, Rowinsky E, Hakes T, Reichman B, Jones W, Lewis Jr JL, et al. Phase I trial of intraperitoneal taxol: a Gynecoloic Oncology Group study. J Clin Oncol. 1992;10:1485–91.PubMed
11.
Markman M, Bundy BN, Alberts DS, Fowler JM, Clark-Pearson DL, Carson LF, et al. Phase III trial of standard-dose intravenous cisplatin plus paclitaxel vs moderately high-dose carboplatin followed by intravenous paclitaxel and intraperitoneal cisplatin in small-volume stage III ovarian carcinoma: an intergroup study of the Gynecologic Oncology Group, Southwestern Oncology Group, and Eastern Cooperative Oncology Group. J Clin Oncol. 2001;19:1001–7.PubMed
12.
Alberts DS, Liu PY, Hannigan EV, O'Toole R, Williams SD, Young JA, et al. Intraperitoneal cisplatin plus intravenous cyclophosphamide vs intravenous cisplatin plus intravenous cyclophosphamide for stage III ovarian cancer. N Engl J Med. 1996;335:1950–5.PubMedCrossRef
13.
Armstrong DK, Bundy B, Wenzel L, Huang HQ, Baergen R, Lele S, et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006;354:34–43.PubMedCrossRef
14.
Trimble EL, Alvarez RD. Intraperitoneal chemotherapy and the NCI clinical announcement. Gynecol Oncol. 2006;103(2 Suppl 1):S18–9.PubMedCrossRef
15.
Landrum LM, Java J, Mathews CA, Lanneau Jr GS, Copeland LJ, Armstrong DK, et al. Prognostic factors for stage III epithelial ovarian cancer treated with intraperitoneal chemotherapy: a Gynecologic Oncology Group study. Gynecol Oncol. 2013;130:12–8.PubMedCrossRef
16.
Sabbatini PJ, Hensley ML, et al. Progression-free and overall survival of a modified outpatient regimen of primary intravenous/intraperitoneal paclitaxel and intraperitoneal cisplatin in ovarian,fallopian tube, and primary peritoneal cancer. Gynecol Oncol. 2012;125(3):621–4.
17.
Nicoletto MO, Padrini R, Galeotti F, Ferrazzi E, Cartei G, Riddi F, et al. Pharmacokinetics of intraperitoneal hyperthermic perfusion with mitoxantrone in ovarian cancer. Cancer Chemother Pharmacol. 2000;45:457–62.PubMedCrossRef
18.
Ohno S, Siddik ZH, Kido Y, Zwelling LA, Bull JM. Thermal enhancement of drug uptake and DNA adducts as a possible mechanism for the effect of sequencing hyperthermia on cisplatin-induced cytotoxicity in L1210 cells. Cancer Chemother Pharmacol. 1994;34:302–6.PubMedCrossRef
19.
20.
Robins HI. Role of whole-body hyperthermia in the treatment of neoplastic disease: its current status and future prospects. Cancer Res. 1984;44(Suppl):4878s–83.PubMed
21.
Shiu MH, Fortner JG. Intraperitoneal hyperthermic treatment of implanted peritoneal cancer in rats. Cancer Res. 1980;40:4081–4.PubMed
22.
Larkin JM. A clinical investigation of total-body hyperthermia as cancer therapy. Cancer Res. 1979;39(6 Pt 2):2252–4.PubMed
23.
Kowal CD, Bertino JR. Possible benefits of hyperthermia to chemotherapy. Cancer Res. 1979;39(6 Pt 2):2285–9.PubMed
24.
Johnson RJ, Subjeck JR, Moreau DZ, Kowal H, Yakar D. Radiation and hyperthermia. Bull N Y Acad Med. 1979;55:1193–204.PubMedCentralPubMed
25.
Weisberger AS, Levine B, Storaasli JP. Use of nitrogen mustard in treatment of serous effusions of neoplastic origin. JAMA. 1955;159:1704–7.
26.
Jones RB, Myers CE, Guarino AM, Dedrick RL, Hubbard SM, DeVita VT. High volume intraperitoneal chemotherapy (“belly bath”) for ovarian cancer. Pharmacologic basis and early results. Cancer Chemother Pharmacol. 1978;1:161–6.PubMed
27.
Potter ME, Partridge EE, Shingleton HM, Soong SJ, Kim RY, Hatch KD, et al. Intraperitoneal chromic phosphate in ovarian cancer: risks and benefits. Gynecol Oncol. 1989;32:314–8.PubMedCrossRef
28.
Spratt JS, Adcock RA, Muskovin M, Sherrill W, McKeown J. Clinical delivery system for intraperitoneal hyperthermic chemotherapy. Cancer Res. 1980;40:256–60.PubMed
29.
Sugarbaker PH. Complete parietal and visceral peritonectomy of the pelvis for advanced primary and recurrent ovarian cancer. Cancer Treat Res. 1996;81:75–87.PubMedCrossRef
30.
Gori J, Castano R, Toziano M, Habich D, Staringer J, De Quiros DG, et al. Intraperitoneal hyperthermic chemotherapy in ovarian cancer. Int J Gynecol Cancer. 2005;15:233–9.PubMedCrossRef
31.
Cohen JD, Robins HI. Whole body hyperthermia and intraperitoneal carboplatin in residual ovarian cancer. Adv Exp Med Biol. 1990;267:197–202.PubMedCrossRef
32.
Steller MA, Egorin MJ, Trimble EL, Bartlett DL, Zuhowski EG, Alexander HR, et al. A pilot phase I trial of continuous hyperthermic peritoneal perfusion with high-dose carboplatin as primary treatment of patients with small-volume residual ovarian cancer. Cancer Chemother Pharmacol. 1999;43:106–14.PubMedCrossRef
33.
Hager ED, Dziambor H, Hohmann D, Muhe N, Strama H. Intraperitoneal hyperthermic perfusion chemotherapy of patients with chemotherapy-resistant peritoneal disseminated ovarian cancer. Int J Gynecol Cancer. 2001;11 Suppl 1:57–63.PubMedCrossRef
34.
Piso P, Dahlke MH, Loss M, Schlitt HJ. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal carcinomatosis from ovarian cancer. World J Surg Oncol. 2004;2:21.PubMedCentralPubMedCrossRef
35.
Ryu KS, Kim JH, Ko HS, Kim JW, Ahn WS, Park YG, et al. Effects of intraperitoneal hyperthermic chemotherapy in ovarian cancer. Gynecol Oncol. 2004;94:325–32.PubMedCrossRef
36.
Rufian S, Munoz-Casares FC, Briceno J, Diaz CJ, Rubio MJ, Ortega R, et al. Radical surgery-peritonectomy and intraoperative intraperitoneal chemotherapy for the treatment of peritoneal carcinomatosis in recurrent or primary ovarian cancer. J Surg Oncol. 2006;94:316–24.PubMedCrossRef
37.
Bae JH, Lee JM, Ryu KS, Lee YS, Park YG, Hur SY, et al. Treatment of ovarian cancer with paclitaxel- or carboplatin-based intraperitoneal hyperthermic chemotherapy during secondary surgery. Gynecol Oncol. 2007;106:193–200.PubMedCrossRef
38.
Lentz SS, Miller BE, Kucera GL, Levine EA. Intraperitoneal hyperthermic chemotherapy using carboplatin: a phase I analysis in ovarian carcinoma. Gynecol Oncol. 2007;106:207–10.PubMedCrossRef
39.
Kusamura S, Dominique E, Baratti D, Younan R, Deraco M. Drugs, carrier solutions and temperature in hyperthermic intraperitoneal chemotherapy. J Surg Oncol. 2008;98:247–52.PubMedCrossRef
40.
Pavlov MJ, Kovacevic PA, Ceranic MS, Stamenkovic AB, Ivanovic AM, Kecmanovic DM. Cytoreductive surgery and modified heated intraoperative intraperitoneal chemotherapy (HIPEC) for advanced and recurrent ovarian cancer — 12-year single center experience. Eur J Surg Oncol. 2009;35:1186–91.PubMedCrossRef
41.
Bakrin N, Cotte E, Golfier F, Gilly FN, Freyer G, Helm W, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for persistent and recurrent advanced ovarian carcinoma: a multicenter, prospective study of 246 patients. Ann Surg Oncol. 2012;19:4052–8.PubMedCrossRef
42.
Helm CW, Richard SD, Pan J, Bartlett D, Goodman MD, Hoefer R, et al. Hyperthermic intraperitoneal chemotherapy in ovarian cancer: first report of the HYPER-O registry. Int J Gynecol Cancer. 2010;20:61–9.PubMedCrossRef
43.
Zanon C, Clara R, Chiappino I, Bortolini M, Cornaglia S, Simone P, et al. Cytoreductive surgery and intraperitoneal chemohyperthermia for recurrent peritoneal carcinomatosis from ovarian cancer. World J Surg. 2004;28:1040–5.PubMedCrossRef
44.
Cotte E, Glehen O, Mohamed F, Lamy F, Falandry C, Golfier F, et al. Cytoreductive surgery and intraperitoneal chemo-hyperthermia for chemo-resistant and recurrent advanced epithelial ovarian cancer: prospective study of 81 patients. World J Surg. 2007;31:1813–20.PubMedCrossRef
45.
Raspagliesi F, Kusamura S, Campos Torres JC, de Souza GA, Ditto A, Zanaboni F, et al. Cytoreduction combined with intraperitoneal hyperthermic perfusion chemotherapy in advanced/recurrent ovarian cancer patients: the experience of National Cancer Institute of Milan. Eur J Surg Oncol. 2006;32:671–5.PubMedCrossRef
46.
Yoshida Y, Sasaki H, Kurokawa T, Kawahara K, Shukunami K, Katayama K, et al. Efficacy of intraperitoneal continuous hyperthermic chemotherapy as consolidation therapy in patients with advanced epithelial ovarian cancer: a long-term follow-up. Oncol Rep. 2005;13:121–5.PubMed
47.
Kim JH, Lee JM, Ryu KS, Lee YS, Park YG, Hur SY, et al. Consolidation hyperthermic intraperitoneal chemotherapy using paclitaxel in patients with epithelial ovarian cancer. J Surg Oncol. 2010;101:149–55.PubMed
48.
Frenel JS, Leux C, Pouplin L, Ferron G, Berton Rigaud D, Bourbouloux E, et al. Oxaliplatin-based hyperthermic intraperitoneal chemotherapy in primary or recurrent epithelial ovarian cancer: a pilot study of 31 patients. J Surg Oncol. 2011;103:10–6.PubMedCrossRef
49.
Ansaloni L, Agnoletti V, Amadori A, Catena F, Cavaliere D, Coccolini F, et al. Evaluation of extensive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced epithelial ovarian cancer. Int J Gynecol Cancer. 2012;22:778–85.PubMedCrossRef
50.•
Ceelen WP, Van Nieuwenhove Y, Van Belle S, Denys H, Pattyn P. Cytoreduction and hyperthermic intraperitoneal chemoperfusion in women with heavily pretreated recurrent ovarian cancer. Ann Surg Oncol. 2012;19:2352–9. A contemporary study exploring HIPEC in the recurrent setting. Despite multiple prior lines of therapy, HIPEC was deemed safe.PubMedCrossRef
51.••
Deraco M, Kusamura S, Virzi S, Puccio F, Macri A, Famulari C, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as upfront therapy for advanced epithelial ovarian cancer: multi-institutional phase-II trial. Gynecol Oncol. 2011;122:215–20. One of the largest phase II studies exploring the efficacy and toxicity of HIPEC in ovarian cancer patients. This study illustrated the feasability of this approach in appropriately selected patietns, with acceptable oncologic outcomes.PubMedCrossRef
52.
Di Giorgio A, Naticchioni E, Biacchi D, Sibio S, Accarpio F, Rocco M, et al. Cytoreductive surgery (peritonectomy procedures) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of diffuse peritoneal carcinomatosis from ovarian cancer. Cancer. 2008;113:315–25.PubMedCrossRef
53.
Fagotti A, Costantini B, Petrillo M, Vizzielli G, Fanfani F, Margariti PA, et al. Cytoreductive surgery plus HIPEC in platinum-sensitive recurrent ovarian cancer patients: a case-control study on survival in patients with two year follow-up. Gynecol Oncol. 2012;127:502–5.PubMedCrossRef
54.•
Fagotti A, Costantini B, Vizzielli G, Perelli F, Ercoli A, Gallotta V, et al. HIPEC in recurrent ovarian cancer patients: morbidity-related treatment and long-term analysis of clinical outcome. Gynecol Oncol. 2011;122:221–5. Contemporary article focusing on HIPEC related morbidity.PubMedCrossRef
55.
Lim MC, Kang S, Choi J, Song YJ, Park S, Seo SS, et al. Hyperthermic intraperitoneal chemotherapy after extensive cytoreductive surgery in patients with primary advanced epithelial ovarian cancer: interim analysis of a phase II study. Ann Surg Oncol. 2009;16:993–1000.PubMedCrossRef
56.
Verwaal VJ, van Ruth S, de Bree E, van Sloothen GW, van Tinteren H, Boot H, et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy vs systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol. 2003;21:3737–43.PubMedCrossRef
57.
Markman M. Hyperthermic intraperitoneal chemotherapy in the management of ovarian cancer: a critical need for an evidence-based evaluation. Gynecol Oncol. 2009;113:4–5.PubMedCrossRef
58.
Ansaloni L, De Iaco P, Frigerio L. Re: “cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as upfront therapy for advanced epithelial ovarian cancer: multi-institutional phase II trial.” Proposal of a clinical trial of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in advanced ovarian cancer, the CHORINE study. Gynecol Oncol. 2012;125:279–81.PubMedCrossRef
59.
Verwaal VJ, van Tinteren H, Ruth SV, Zoetmulder FA. Toxicity of cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy. J Surg Oncol. 2004;85:61–7.PubMedCrossRef
60.
Schierl R, Novotna J, Piso P, Bohlandt A, Nowak D. Low surface contamination by cis/oxaliplatin during hyperthermic intraperitoneal chemotherapy (HIPEC). Eur J Surg Oncol. 2012;38:88–94.PubMedCrossRef
61.
Li G, Gu R, Wen X, Wei D, Ming X, Chen H. The effect of early enteral nutrition on hyperthermic intraoperative intraperitoneal chemotherapy-induced mucosal permeability following gastrectomy. J Parenter Enteral Nutr. 2012;36:213–8.CrossRef
62.
Kusamura S, Baratti D, Deraco M. Multidimensional analysis of the learning curve for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal surface malignancies. Ann Surg. 2012;255:348–56.PubMedCrossRef
63.
Duckworth KE, McQuellon RP, Russell GB, Cashwell CS, Shen P, Stewart JHt, et al. Patient rated outcomes and survivorship following cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CS + HIPEC). J Surg Oncol. 2012;15;106(4):376–80.
64.
Parson EN, Lentz S, Russell G, Shen P, Levine EA, Stewart JH. Outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal surface dissemination from ovarian neoplasms. Am J Surg. 2011;202:481–6.PubMedCrossRef
65.
Konigsrainer I. Selection criteria for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in gastric cancer. World J Gastroenterol. 2011;17:4153–6.PubMedCrossRef
66.
Hill AR, McQuellon RP, Russell GB, Shen P, Stewart JH, Levine EA. Survival and quality of life following cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis of colonic origin. Ann Surg Oncol. 2011;18:3673–9.PubMedCentralPubMedCrossRef
Metadata
Title
Intraperitoneal Chemotherapy from Armstrong to HIPEC: Challenges and Promise
Authors
Ramez N. Eskander, MD
James Cripe, MD
Robert E. Bristow, MD
Publication date
01-03-2014
Publisher
Springer US
Published in
Current Treatment Options in Oncology / Issue 1/2014
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI
https://doi.org/10.1007/s11864-013-0264-2

Other articles of this Issue 1/2014

Current Treatment Options in Oncology 1/2014 Go to the issue

Breast Cancer (CI Falkson, Section Editor)

When and How Do I Use Neoadjuvant Chemotherapy for Breast Cancer?

Genitourinary Cancers (W Oh, Section Editor)

Intermittent Androgen Deprivation Therapy in Advanced Prostate Cancer

Breast Cancer (CI Falkson, Section Editor)

How Do I Follow Patients With Early Breast Cancer After Completing Adjuvant Therapy

Genitourinary Cancers (W Oh, Section Editor)

Beyond Sipuleucel-T: Immune Approaches to Treating Prostate Cancer

Gynecologic Cancers (RJ Morgan, Section Editor)

Updates in Systemic Treatment for Metastatic Cervical Cancer

Breast Cancer (CI Falkson, Section Editor)

How Do I Recommend Extended Adjuvant Hormonal Therapy?
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits