Intraperitoneal Chemotherapy: Long-Term Outcomes Revive a Long-Running Debate

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  In conclusion, our cumulative experience with IP therapy has demonstrated sustained improvement in median OS (HR, 0.76) without an impact on long-term disease-specific mortality at the expense of increased complexity, toxicity, and cost. Similar gains in OS have been observed with other approaches, including IV therapy that incorporates dose-dense weekly paclitaxel, especially in high-risk patients with larger-volume residual disease.⁸ Important questions remain regarding patient selection (in terms of the extent of residual disease), mechanism of action, treatment modifications, timing, optimal number of IP cycles, and integration with targeted agents. Some of these questions will be addressed in the context of GOG-0252, and it remains to be seen whether better IV chemotherapy might match the outcomes previously associated with IP chemotherap