Intraperitoneal Chemotherapy Could Benefit Patients with Ovarian Cancer

Researchers in a recent study have found that chemotherapy delivered into the abdomen (intraperitoneal, IP) and intravenously (IV) is more effective than IV chemotherapy alone in patients with advanced ovarian cancer who had prior surgery.

The study, presented today at the 2016 American Society of Clinical Oncology Annual Meeting, enrolled 275 women with stages 3b to 4 epithelial ovarian cancers. Approximately 82% of patients had stage 3C where the cancer spread to the intraperitoneal cavity.

All patients received neoadjuvant platinum-based chemotherapy followed by debulking surgery. After surgery, 200 patients were randomly assigned to receive IV chemotherapy or IV and IP treatment.

Researchers found that 42.4% of patients receiving IV treatment showed disease worsening at 9 months and only 23.3% of patients receiving IV/IP treatment had disease worsening, according to the study.

Median overall survival was 59.3 months for patients receiving IV/IP treatment and 38.1 months for IV treatment. However, this was not statistically significant. Researchers found similar progression-free survival in both groups.

"Although this randomized phase 2 trial was not statistically powered to evaluate survival, our results offer information on how to incorporate IP chemotherapy when women receive neoadjuvant chemotherapy followed by debulking surgery,” said lead study author Helen Mackay, MD. “The findings also offer supportive and additional information to the previous published adjuvant randomized trials that showed an improvement in overall survival when IP chemotherapy was given following initial optimal debulking surgery."

Patients who received IP/IV chemotherapy had a lower rate of severe side effects than patients who received IV treatment (16% and 23%, respectively).

Researchers plan to analyze tissue samples from the study to see if there are certain characteristics that can lead to better outcomes for IP treatment than IV chemotherapy.

“At this early time frame, we already see that women are doing better with IP chemotherapy, without a significant difference in toxicity,” concluded Dr Mackay. “However, women should consider the side effects of IP and IV chemotherapy, as well as recovery from cancer surgery, when discussing this option with their doctors.”