IP chemotherapy should be offered as an option for advanced ovarian cancer in women who have had successful surgery, regardless of whether they received neoadjuvant chemotherapy.— Don Dizon, MD
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Don Dizon, MD, Chair of ASCO’s Cancer Communications Committee, congratulated the authors of the OV21/PETROC study. “This is another example of international collaboration. The authors looked at the role of IP therapy in women who got primary chemotherapy before surgery, and at least in this phase II trial, there is a benefit in terms of disease progression. “The question of optimal treatment for women with ovarian cancer who underwent primary chemotherapy followed by surgery has been an open one. This is the first to show that IP treatment may be a valid option,” Dr. Dizon stated.
Previously, three randomized trials have shown a benefit for IP in women with optimally resected disease, he continued. Unlike these three trials, which were conducted before neoadjuvant chemotherapy was commonly used, OV21/PETROC included women treated with neoadjuvant chemotherapy.
Removing Barrier to Its Use
When asked why oncologists have been reluctant to use IP chemotherapy, Dr. Dizon said three factors have discouraged its use: a comfort level with an IP port, the toxicity of cisplatin, and an inconvenient schedule.
One barrier has been removed—substituting carboplatin for cisplatin did not compromise quality of life. In fact, in this trial, the data safety monitoring committee recommended going forward with IP carboplatin rather than the more commonly used agent, cisplatin. Although the data are provocative, IP therapy is still not likely to be widely adopted on the basis of this trial, Dr. Dizon noted.
“Still, IP chemotherapy should be offered as an option for advanced ovarian cancer in women who have had successful surgery, regardless of whether they received neoadjuvant chemotherapy,” Dr. Dizon stated.
He also emphasized that women with ovarian cancer should be treated by a gynecologic oncologist to receive optimal care. “But there can be access issues depending on the region of the country,” he acknowledged. ■
Disclosure: Dr. Dizon reported no potential conflicts of interest.
The role of intraperitoneal (IP) chemotherapy in the treatment of advanced ovarian cancer has been debated for a long time. According to a new study presented at the 2016 ASCO Annual Meeting, a combination of IP and intravenous (IV) chemotherapy appears more effective than IV chemotherapy alone in...