March 29, 2021 2 min read Source/Disclosures Published by: Source: Chambers LM, et al. Abstract 11583. Provided at: Society of Gynecologic Oncology Yearly Fulfilling on Women’s Cancer(virtual meeting); March 19-25, 2021
. Disclosures: Chambers reports no pertinent financial disclosures. Please see the abstract for all other researchers’ relevant monetary disclosures.
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The addition of paclitaxel to cisplatin in a hyperthermic intraperitoneal chemotherapy program doubled PFS amongst women with innovative epithelial ovarian cancer undergoing interval debulking surgical treatment, study outcomes showed.
“Treatments to enhance oncologic results are urgently needed for ladies with sophisticated ovarian cancer, so we were both shocked and ecstatic to see such a favorable result in ladies treated with the mix of paclitaxel/cisplatin,” Laura M. Chambers, DO, a fellow in the division of gynecologic oncology at Cleveland Center, informed Healio after providing the findings during the virtual Society of Gynecologic Oncology Annual Fulfilling on Women’s Cancer.
Data were originated from Chambers LM, et al. Abstract 11583. Provided at: Society of Gynecologic Oncology Annual Fulfilling on Women’s Cancer(virtual conference); March 19-25, 2021.
The single-institution cohort research study consisted of information of 75 females with phase III or phase IV, high-grade epithelial ovarian cancer treated at Cleveland Center from 2017 to 2020. All women went through interval debulking surgical treatment with hypothermic intraperitoneal chemotherapy, administered at the primary surgeon’s discretion, and had at least 6 months of follow-up.
Ladies got hyperthermic intraperitoneal chemotherapy with either cisplatin dosed at 80 mg/m2 to 100 mg/m2 for 90 minutes (n = 42), or paclitaxel dosed at 135 mg/m2 to 175 mg/m2 for 90 minutes plus cisplatin dosed 80 mg/m2 to 100 mg/m2 for 45 minutes (n = 33), in a perfusate of typical saline at 41 ° C to 43 ° C for 90 minutes.
Ladies in the cisplatin-alone and paclitaxel-cisplatin combination groups had comparable demographic characteristics, consisting of mean age (64.7 years vs. 62.6 years), race (white, 87.8% vs. 93.9%; Black, 4.9% vs. 6.1%), medical comorbidities and American Society of Anesthesiologists score. Many had phase III disease (64.3% vs. 78.7%) and serous histology (100% vs. 93.9%).
Researchers analyzed PFS, defined as months from hypothermic intraperitoneal chemotherapy to the date of reoccurrence, and perioperative results among the women.
Results, stratified by treatment routine, showed PFS of 22.2 months in the paclitaxel-cisplatin group vs. 11 months in the cisplatin-alone group (HR = 0.41; 95% CI, 0.2-0.83) and 1-year RFS of 82.9% (95% CI, 69.3-96.6) vs. 36.7% (95% CI, 18.4-55.1).
“A mix of paclitaxel-cisplatin is associated with improved progression-free survival compared with cisplatin alone, which has actually been formerly studied in randomized clinical trials,” Chambers said.” [Additional], the addition of paclitaxel to cisplatin was not connected with worse perioperative outcomes or toxicity.”
The cisplatin-only group had a longer personnel time than the combination group (6.1 hours vs. 5.3 hours), but scientists observed no significant distinctions in surgical procedures carried out, including little bowel (9.5% vs. 9.1%) and big bowel resection (23.8% vs. 18.1%); postoperative adverse events as measured by the Accordion Seriousness Grading System (none, 42.9% vs. 42.4%; mild, 21.4% vs. 27.3%; moderate, 23.8% vs. 15.2%; extreme, 9.5% vs. 15.2%; fatal, 2.4% vs. 0%); and need for intraoperative blood transfusion (42.9% vs. 57.6%) and intraoperative pressor support (71.4% vs. 81.8%).
Chambers acknowledged the research study’s restrictions, consisting of lack of randomization, possible selection bias, restricted follow-up of 15.7 months and usage of data from a single-institution computer registry. However, she said that it was the very first to compare cisplatin alone with the combination of paclitaxel and cisplatin for these ladies.
More research is needed to validate the findings in larger cohorts and determine the effect of hypothermic intraperitoneal chemotherapy on OS, she included.
“Our company believe that clinicians ought to consider making use of mix of paclitaxel with cisplatin during hyperthermic intraperitoneal chemotherapy in females with advanced ovarian cancer going through interval debulking,” Chambers stated.
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