A Comparison of Intravenous versus Intraperitoneal Chemotherapy for the Initial Treatment of Ovarian Cancer

Kirmani, Saeeda; Braly, Patricia S.; McClay, Edward F.; Saltztein, Sidney L.; Plaxe, Steven C.; Kim, Sinil; Cates, Charles; Howell, Stephen B.

doi:10.1006/gyno.1994.1220

Cited by 97 publications

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“…Two early studies in this report did not limit eligibility based on residual disease, and neither demonstrated a diminution of benefit by infusion technique in those with bulkier postoperative residuum [17,19]. In addition, two studies allowed stage IV patients to be randomized [17,20]. A detailed description of the minority of stage IV patients included in these trials is lacking; however, no survival differences are reported in these patients.…”

Section: Discussionmentioning

confidence: 89%

“…For example, it is unclear from the reported large trials that only patients with the most limited postoperative residual disease benefit from intraperitoneal administration of chemotherapy. Two early studies in this report did not limit eligibility based on residual disease, and neither demonstrated a diminution of benefit by infusion technique in those with bulkier postoperative residuum [17,19]. In addition, two studies allowed stage IV patients to be randomized [17,20].…”

Section: Discussionmentioning

confidence: 93%

“…The single-center phase III clinical trial by Kirmani et al [17] represents the first large-scale study of intraperitoneal chemotherapy in ovarian cancer patients. Stage IIC to stage IV patients were eligible, and postoperative residual disease was recorded as 1 cm or less or greater than 1 cm.…”

Section: Kirmani Et Al (1994)mentioning

confidence: 99%

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Historical progress in the initial management of ovarian cancer: Intraperitoneal chemotherapy

Coleman

Sood²

2006

Curr Oncol Rep

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Despite measured improvement in survival with the introduction of the platinates and taxanes in treatment of advanced ovarian cancer, little additional progress has been made with conventional cytotoxic agents. Recently, the Gynecologic Oncology Group (GOG) published data from a study evaluating the merits of intraperitoneal chemotherapy in women with advanced, optimally cytoreduced ovarian cancer. They documented a significant advantage in progression-free and overall survival for the experimental regimen, a combination of intravenous paclitaxel and intraperitoneal cisplatin and paclitaxel, compared with standard intravenous cisplatin and paclitaxel chemotherapy. The intraperitoneal regimen was substantially more toxic and was associated with reduced short-term quality of life. The GOG trial joins six other published phase III trials since 1994 comparing intravenous with intraperitoneal chemotherapy in advanced-stage epithelial ovarian cancer. A recent meta-analysis suggests a 21% reduction in the hazard for progression (four studies) and death (seven studies). Reluctance to adopt a new standard of care is rooted in toxicity concerns. Further evaluation is warranted to clarify unanswered questions regarding administration schedule, agents, techniques, number of courses, and patient eligibility for intraperitoneal chemotherapy.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 93%

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Historical progress in the initial management of ovarian cancer: Intraperitoneal chemotherapy

Coleman

Sood²

2006

Curr Oncol Rep

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“…Several smaller randomized trials of IP chemotherapy have been conducted in this population that have failed to show survival benefits when compared with IV chemotherapy [4,[18][19][20]. Unfortunately, these trials were seriously underpowered, used differing doses of IP chemotherapies, and used differing IV agents and schedules than did the larger randomized trials.…”

Section: Front-line Therapy For Optimally Debulked Patientsmentioning

confidence: 92%

Intraperitoneal chemotherapy for ovarian cancer

Friberg

Fleming

2003

Curr Oncol Rep

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Intraperitoneal chemotherapy provides a means by which high concentrations of drugs and long durations of tissue exposure can be attained at the peritoneal surface. It has been studied widely in ovarian cancer, a disease in which intra-abdominal progression remains the major source of morbidity and mortality. Three large randomized trials have shown improved survival in optimally debulked patients who were treated with intraperitoneal chemotherapy as part of a front-line regimen, yet it has not become part of usual therapy. Several factors have contributed to the reluctance to adopt intraperitoneal therapy, including technical issues related to drug delivery and the fact that all of the large randomized trials employed intraperitoneal cisplatin, which has more toxicity than intravenous carboplatin, the current standard of care. Future research is needed for further definition of the clinical benefit of intraperitoneal chemotherapy, modification of existing regimens to minimize side effects, and exploration of intraperitoneal biologic, immunologic, and gene therapy techniques.

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“…Vier von 7 randomisierten Phase-III-Studien, die die i.p-Platingabe mit der intravenösen verglichen, zeigten keinen signifikanten Vorteil; möglicherweise reichten die geringen Fallzahlen nicht aus, um einen möglichen Unterschied zu detektieren. In den größeren Phase-III-Studien der GOG, Protokoll 104 und 172, wurde jeweils ein statistisch signifikanter Über-lebensvorteil durch die i.p.-Chemotherapie nachgewiesen, in der GOG 114 ein signifikanter Vorteil im PFS, aber nicht im Gesamtüberleben [1,2,8,15,16,20,22].…”

Section: Hintergrundunclassified

Ovarialkarzinom

Bois¹,

Schmalfeldt²,

Meier³

et al. 2006

Gynäkologe

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OvarialkarzinomIst die intraperitoneale Therapie wirklich neuer Standard? Gynäkologie aktuellMit der Publikation der Gynecologic Oncology Group Studie (GOG-172-Studie) im "New England Journal of Medicine" im Januar diesen Jahres ist die intraperitoneale Chemotherapie als Therapieoption bei Patientinnen mit Ovarialkarzinom erneut in den Fokus des Interesses gerückt. Das National Cancer Institute (NCI) und amerikanische Fachgesellschaften haben positive Stellungnahmen abgegeben. Die Kommission Ovar der Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) sowie die beiden deutschen Studiengruppen, die AGO Studiengruppe Ovarialkarzinom (AGO-OVAR) und die Nordostdeutsche Gesellschaft für Gynäkologische Onkologie (NOGGO), legen mit dieser Darstellung der Datenlage zur intraperitonealen Chemotherapie beim Ovarialkarzinom eine kritische Bewertung der Pro-und Contra-Argumente vor.

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A Comparison of Intravenous versus Intraperitoneal Chemotherapy for the Initial Treatment of Ovarian Cancer

Cited by 97 publications

References 0 publications

Historical progress in the initial management of ovarian cancer: Intraperitoneal chemotherapy

Historical progress in the initial management of ovarian cancer: Intraperitoneal chemotherapy

Intraperitoneal chemotherapy for ovarian cancer

Ovarialkarzinom

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