Intraperitoneal chemotherapy in patients with advanced ovarian cancer: phase 2 institutional study
Authors: A.S. Tyulyandina, V.М. Nechushkina, L.V. Cherkes, K.Y. Morkhov, A.A. Rumyantsev, I.A. Pokataev, E.V. Glazkova, E.R. Virshke, D.Y. Frantsev, K.I. Zhordania, Y.V. Bujdenok, R.K. Valiev, A.V. Petrovsky, Y.S. Sergeev, I.V. Panichenko, A.A. Bulanov, M.B. Stenina, S.A. Tyulyandin
Background: despite the fact that intraperitoneal (IP) chemotherapy in patients (pts) with ovarian cancer (OC) in 1 line of treatment showed positive results in three randomized studies, this method is still not routine in clinical practice.
Materials and methods: phase 2 study of the first line IP chemotherapy in pts with OC stage Ic – IV after primary optimal debulking was conducted. IP ports were implanted intraoperatively or by laparoscopic approach. Pts were administered every 3 weeks intravenous (IV) paclitaxel 135 mg/m2 day 1, IP cisplatin 75 mg/m2 day 2 and IP paclitaxel 60 mg/
m2 day 8 for 6 cycles.
Results: from 2009 to 2017 64 pts were included in the study. Progression free survival (PFS) was 38,6 months, overall survival (OS) was 79,4 months. In 79,7% of cases, the pts received all planned treatment. In retrospective comparison with similar group of pts who received standard IV chemotherapy in 2007–2017 no any significant difference were found in PFS and OS. A comparative analysis of pts with complete cytoreduction demonstrated significant increase in PFS of 11,7 months after IP chemotherapy than standard IV administration: 38,8 months for IP and 26,9 months for IV (HR 0,53; 95% CI 0,27–0,96; р=0,05). The same trend was observed for pts with stage III–IV: PFS for IP group was 38,6 months and for IV – 22,9 months (HR 0,60; 95% CI 0,36–0,98; p=0,05).
Conclusion: studied IP regimen of chemotherapy is tolerable for majority of pts. The use of IP chemotherapy in first
line OC may be an option in pts with minimal residual tumor after primary cytoreduction.