Alvaro Arjona-Sanchez, MD, Hospital Universitario Reina Sofia, Cordoba, Spain, discusses a randomized phase 3 study investigating the efficacy and safety of adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with locally advanced colon cancer. In this study, the addition of HIPEC with mitomycin C improved the locoregional control rate, following complete surgical resection, for locally advanced colon cancer. Dr Arjona-Sanchez highlights a that this benefit is especially seen among the subgroup of patients with pT4 colon cancer.

These results were first presented at the 2022 European Society of Medical Oncology (ESMO) Congress.

Transcript:

Hello, I'm Alvaro Arjona, Dr. Arjona. I'm a consultant surgeon at Hospital Reina Sofía from Córdoba, Spain. I'm at ESMO 2022. I just presented our clinical trial, HIPECT-4, to prevent peritoneal carcinomatosis in locally advanced colorectal cancer.

The primary end point of the study is to avoid the peritoneal relapse or abdominal relapse, and the peritoneal carcinomatosis in patients who have undergone surgery for locally advanced colorectal cancer. We used HIPEC, hyperthermic intraperitoneal chemotherapy and mitomycin-C, 30 mg/m² over 60 minutes. We recruited more than 180 patients in both groups, with the control being just surgery and the other group was the experimental arm, surgery plus HIPEC.

The two groups were very balanced, with similar clinical and tumoral characteristics, and also in the pathological characteristics. The end point was relapse in the abdominal cavity, and locoregional relapse was improved among patients that had been treated with HIPEC, compared to patients treated with surgery alone. This means that the patients treated with surgery and HIPEC have less locoregional relapse and less peritoneal recurrence than the patients in the control arm.

Using HIPEC during surgery, we demonstrated, does not increase morbidity for these patients and HIPEC was very safe.

We have analyzed the definitive pT4 colon cancer patients and the results were better than the intention-to-treat analysis, with a less locoregional recurrence and less incidents of peritoneal carcinomatosis in this patient subgroup, with the use of HIPEC with mitomycin-C.

In conclusion, we have used a prophylactic treatment in order to avoid the peritoneal relapse for this patient population and this treatment worked. The use of HIPEC with mitomycin-C is safe, without increasing the morbidity and we have demonstrated the effectivity of this treatment to further avoid the peritoneal relapse.

Source:

Arjona-Sanchez A, Cano-Osuna MT, Gutierrez A, et al. Adjuvant hyperthermic intraperitoneal chemotherapy in locally advanced colon cancer (HIPECT4): A randomized phase III study. Presented at ESMO Congress; September 9-13, 2022; Paris, France. Abstract 3140.