
Administering hyperthermic intraperitoneal chemotherapy (HIPEC) during cytoreductive surgery for recurrent ovarian cancer helps prolong overall survival, according to the results of the phase III open-label CHIPOR trial.
CHIPOR was conducted at 31 sites across France, Belgium, Spain, and Canada and included 415 female patients with first relapse of epithelial ovarian cancer at least 6 months after completing platinum-based chemotherapy. All patients had a WHO performance status of <2 and were amenable to complete cytoreductive surgery.
The patients were randomly assigned to receive HIPEC (cisplatin 75 mg/m2 in 2 L/m2 of serum at 41 °C for 60 minutes; n=207) or not (n=208) during the surgical procedure. The primary endpoint was overall survival, analysed on an intention-to-treat basis in all patients who underwent randomization.
Over a median follow-up of 6.2 years, 268 (65 percent) patients died, including 126 (61 percent) in the HIPEC group and 142 (68 percent) in the no-HIPEC group. The median overall survival was 54.3 months (95 percent confidence interval [CI], 41.9–61.7) with HIPEC vs 45.8 months (95 percent CI, 38.9–54.2) without HIPEC. In addition, HIPEC correlated with a 27-percent reduction in the risk of progression or death (stratified hazard ratio 0.73, 95 percent CI, 0.56–0.96; p=0.024).
In terms of safety, grade 3 or worse adverse events (AEs) within 60 days after surgery occurred in 102 (49 percent) patients in the HIPEC group and in 56 (27 percent) in the no-HIPEC group. Anaemia (23 percent vs 14 percent) was the most common AE, followed by hepatotoxicity (11 percent vs 9 percent), electrolyte disturbance (14 percent vs 1 percent), and renal failure (10 percent vs 1 percent). A total of three patients died within 60 days of surgery, all in the no-HIPEC group.
The findings suggest that platinum-based HIPEC may be considered when treating patients with late first relapse of high-grade serous or high-grade endometrioid ovarian cancer amenable to complete cytoreductive surgery in order to extend overall survival.