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Joyce F. Liu, MD, MPH
Joyce F. Liu, MD, MPH
Posted: Tuesday, January 21, 2025
The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery may improve clinical outcomes for women who experience relapse of epithelial ovarian cancer, according to the results of the randomized phase III CHIPOR trial, published in The Lancet Oncology. Despite the increased number of toxicities associated with this treatment strategy, platinum-based HIPEC should be considered for women with high-grade serous or high-grade endometrioid ovarian cancer to improve their overall survival, explained Jean-Marc Classe, MD, of the Institut de Cancérologie de l’Ouest, Saint Herblain, France, and colleagues.
“To the best of our knowledge, CHIPOR is the largest randomized trial to prospectively evaluate HIPEC in patients being treated for recurrent ovarian cancer,” the authors stated.
From 2011 to 2021, a total of 415 women with first relapse of epithelial ovarian cancer were recruited for the study; they were from 31 sites in France, Spain, Belgium, and Canada. All patients completed six cycles of platinum-based chemotherapy before beginning cytoreductive surgery. Patients were randomly assigned to receive HIPEC (n = 207) or not (n = 208). Patients were monitored postoperatively to assess their clinical outcomes.
The study authors reported significantly improved overall survival in women treated with combined HIPEC and cytoreductive surgery (mean overall survival = 54.3 months) compared with women treated with cytoreductive surgery alone (mean overall survival = 45.8 months, stratified hazard ratio = 0.73). At the median follow-up period, 61% of patients treated with HIPEC had died, and 68% of patients treated with cytoreductive surgery alone had died. Furthermore, treatment-related adverse events within 60 days of surgery were higher in patients who received HIPEC (49%) compared with those who did not (27%). The most common adverse events included anemia (23%), electrolyte disturbances (14%), hepatotoxicity (11%), and renal failure (10%).
Disclosure: For full disclosures of the study authors, visit thelancet.com.
