HIPEC During Surgery Improves Long-Term Survival With Stage III Ovarian Cancer

The researchers reported new, long-term follow-up results from their open-label, randomized, controlled, phase III study of 245 patients, aged 18–76 years, who had stage III epithelial ovarian, fallopian tube, or peritoneal cancer that had not progressed during neoadjuvant treatment. They randomly assigned patients to undergo cytoreductive surgery with (n = 122) or without (n = 123) HIPEC. Those in the HIPEC arm received 100 mg/m² cisplatin via HIPEC at the end of surgery, sodium thiosulfate during and after HIPEC, and an additional three cycles of carboplatin (AUC = 5–6 mg/ml per minute) and paclitaxel (175 mg/m²) once every three weeks. 

After more than 10 years of follow-up, median progression-free survival (PFS) was 14.3 months in the HIPEC arm and 10.7 months in the surgery-alone arm. Five-year PFS was 12.3% and 6.6%, respectively, and 10-year PFS was 10.1% and 6.6%, respectively. Median OS was 44.9 months in the HIPEC arm and 33.3 months in the surgery-alone arm. Five-year OS was 36.9% and 19.7%, respectively, and 10-year OS was 16.1% and 10.9%, respectively. 

“This is the first study, to our knowledge, to provide long-term survival data from a randomized trial of HIPEC in primary ovarian cancer,” the researchers concluded (https://doi.org/10.1016/S1470-2045(23)00396-0). “These survival benefits were consistent across prespecified and post-hoc patient subgroups.”  

They added that trials investigating the combination of HIPEC with other treatments (e.g., immunotherapy, adjuvant intraperitoneal chemotherapy) are currently underway and that future research should explore “biomarkers to predict a patient’s response to HIPEC [because] gene expression signatures, histopathologic data, and immunohistochemical markers could help to select patients for HIPEC.” 

Learn about the nursing considerations for HIPEC and other intraperitoneal chemotherapy on the Oncology Nursing Podcast Episode 252: Intraperitoneal Administration: The Oncology Nurse’s Role (https://www.ons.org/podcasts/episode-252-intraperitoneal-administration-oncology-nurses-role).