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Monday, June 06, 2016

Adding IP slows ovarian cancer progression



ASCO 2016
 03 Jun 2016
 
For some women with advanced ovarian cancer that was successfully treated surgically, delivering chemotherapy into the abdomen (intraperitoneal, or IP) as well as intravenously (IV) appears more effective than IV chemotherapy alone.
For women who were initially treated with chemotherapy prior to surgery (eg., neoadjuvant therapy), the initial results from a randomised phase II trial show that 23.3% of women who received IP and IV chemotherapy had disease progression at nine months, vs. 42.2% of those who received IV chemotherapy alone.
The study was featured in a press briefing, presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting.

According to the authors, the proportion of women with ovarian cancer who receive neoadjuvant therapy prior to surgery is growing.

An estimated 30-40% of all women with epithelial ovarian cancer will receive neoadjuvant chemotherapy in North America and Europe.

Women who undergo optimal debulking surgery following this approach may now be candidates for IP/IV combination chemotherapy.

IP chemotherapy allows the delivery of higher doses of chemotherapy to the tumour, while sparing other parts of the body from side effects.

Several prior randomised clinical trials showed that IP chemotherapy improved outcomes for certain women with ovarian cancer.

However, this is the first randomised study to explore the benefit of IP chemotherapy among women who had received neoadjuvant (pre-surgery) chemotherapy.

“At this early time frame, we already see that women are doing better with IP chemotherapy, without a significant difference in toxicity,” said lead study author Helen Mackay, MD, Divisional Head of Medical Oncology and Hematology at the Sunnybrook Odette Cancer Centre in Toronto, Canada.
“However, women should consider the side effects of IP and IV chemotherapy, as well as recovery from cancer surgery, when discussing this option with their doctors.”

About the Study
This randomised phase II trial compared the efficacy and side effects of two combination chemotherapy regimens in patients with stage IIB-IV epithelial ovarian cancer.
The majority (82%) of women had stage IIIC disease (cancer spread into the intraperitoneal cavity).
In this study, 275 women received neoadjuvant platinum-based chemotherapy, followed by surgery to remove their ovarian cancer (sometimes called debulking).
Following debulking surgery, 200 were randomly assigned to treatment with IV chemotherapy or an IV/IP regimen.
For some women with advanced ovarian cancer that was successfully treated surgically, delivering chemotherapy into the abdomen (intraperitoneal, or IP) as well as intravenously (IV) appears more effective than IV chemotherapy alone.
For women who were initially treated with chemotherapy prior to surgery (eg.,neoadjuvant therapy), the initial results from a randomised phase II trial show that 23.3% of women who received IP and IV chemotherapy had disease progression at nine months, vs. 42.2% of those who received IV chemotherapy alone.
The study will be featured in a press briefing today and presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting.
According to the authors, the proportion of women with ovarian cancer who receive neoadjuvant therapy prior to surgery is growing.
An estimated 30-40% of all women with epithelial ovarian cancer will receive neoadjuvant chemotherapy in North America and Europe.
Women who undergo optimal debulking surgery following this approach may now be candidates for IP/IV combination chemotherapy.
IP chemotherapy allows the delivery of higher doses of chemotherapy to the tumour, while sparing other parts of the body from side effects.
Several prior randomised clinical trials showed that IP chemotherapy improved outcomes for certain women with ovarian cancer.
However, this is the first randomised study to explore the benefit of IP chemotherapy among women who had received neoadjuvant (pre-surgery) chemotherapy.
“At this early time frame, we already see that women are doing better with IP chemotherapy, without a significant difference in toxicity,” said lead study author Helen Mackay, MD, Divisional Head of Medical Oncology and Hematology at the Sunnybrook Odette Cancer Centre in Toronto, Canada.
“However, women should consider the side effects of IP and IV chemotherapy, as well as recovery from cancer surgery, when discussing this option with their doctors.”....

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