Hyperthermic Intraperitoneal Chemotherapy Plus Interval Cytoreductive Surgery Significantly Improved Long-Term Survival Outcomes in Advanced Ovarian Cancer

According to updated survival results from the phase 3 OVHIPEC-1 trial, the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery significantly improved long-term progression-free survival (PFS) and overall survival (OS) among patients with primary stage 3 epithelial ovarian cancer. 

As previously reported, “the addition of [HIPEC] to interval cytoreductive surgery resulted in improved [PFS] and [OS] compared with cytoreductive surgery alone at 4.7 years of follow-up,” stated Lot Aronson, MD, Netherlands Cancer Institute, Amsterdam, and coauthors. These updated data show final survival outcomes after 10 years of follow-up.

In this open-label, controlled study, 245 patients with stage 3 primary epithelial ovarian cancer who did not progress during at least 3 cycles of neoadjuvant carboplatin plus paclitaxel were randomized on a 1-to-1 basis to receive interval cytoreductive surgery with HIPEC (HIPEC arm; n = 122) or without HIPEC (surgery alone arm; n = 123). The primary end point was PFS with a secondary end point of OS in the intention-to-treat (ITT) population at a follow-up of approximately 10 years.

The median PFS was 10.7 years in the surgical arm and 10.4 years in the HIPEC arm. Recurrence, progression, or death occurred in 114 patients in the surgery alone arm and 109 patients in the HIPEC arm (stratified log-rank P = .0008). Median OS was 33.3 months in the surgical arm and 44.9 months in the HIPEC arm. Death occurred in 108 patients in the surgical arm and 100 patients in the HIPEC arm (stratified log-rank P = .011).

“These updated survival results confirm the long-term survival benefit of HIPEC in patients with primary stage 3 epithelial ovarian cancer undergoing interval cytoreductive surgery,” concluded Dr Aronson and coauthors. “The combination of HIPEC with other treatment regimens, such as immunotherapy and adjuvant intraperitoneal chemotherapy, is currently under investigation.”

Source:

Aronson SL, Lopez-Yurda M, Koole SN, et al. Cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy in patients with advanced ovarian cancer (OVHIPEC-1): Final survival analysis of a randomised, controlled, phase 3 trial. Lancet Oncol. Published online: September 11, 2023. doi:10.1016/S1470-2045(23)00396-0