Intraperitoneal Carboplatin with or without Interferon-α in Advanced Ovarian Cancer Patients with Minimal Residual Disease at Second Look: A Prospective Randomized Trial of 111 Patients

Bruzzone, M; Rubagotti, Alessandra; Gadducci, Angiolo; Catsafados, E; Foglia, G; Brunetti, I.; Giannessi, Pier Giorgio; Carnino, F; Iskra, L; Rosso, Riccardo; Martoni, Andrea; Pannuti, F; Lisi, Vincenzo De; Maltoni, Roberta; Ridolfi, Ruggero; Mammoliti, Serafina; Gallo, Luigi; Boccardo, Francesco; Ragni, Nicola; Conte, Pierfranco

doi:10.1006/gyno.1997.4689

Cited by 31 publications

(29 citation statements)

References 24 publications

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“…In 1997, Bruzzone et al [29] reported on a trial of intraperitoneal interferon-␣ (IFN-␣) and carboplatin versus intraperitoneal carboplatin alone. Combination IFN-␣ was associated with significantly more toxicity (leukopenia, anemia, fever, and flu-like symptoms) but showed no significant advantages in rate of progression, median survival, or median progression-free survival.…”

Section: Treatment For Positive Sllmentioning

confidence: 99%

Second-look laparotomy for epithelial ovarian cancer: A reappraisal

Chu

Rubin

2001

Curr Oncol Rep

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Although second-look laparotomy (SSL) has been used in the management of ovarian cancer for over three decades, its current clinical use is limited. On average, over 50% of patients with a clinical complete response are noted to have disease at the time of SLL, emphasizing our lack of accurate noninvasive methods for determining pathologic response. Although findings at SLL have some prognostic significance, there is no definitive evidence that those patients undergoing SLL have improved survival, and even 50% of patients with negative findings at SLL have recurrences. The lack of survival advantage for patients enduring SLL highlights the need to identify consistently effective salvage and consolidation regimens. Few published studies provide definitive evidence regarding efficacy of treatment. Prospective, randomized, controlled trials are needed to evaluate the various therapies available. In general, the performance of SLL should be confined to those patients enrolled in clinical trials.

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Section: Treatment For Positive Sllmentioning

confidence: 99%

Second-look laparotomy for epithelial ovarian cancer: A reappraisal

Chu

Rubin

2001

Curr Oncol Rep

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“…In the other hand, other study demonstrated that intraperitoneal IFN-α does not seem to improve the results achievable with intraperitoneal carboplatin in this subset of patients, while the toxicity and the costs of the combination are higher than with chemotherapy alone (Bruzzone M et al 1997). …”

Section: Ovarian Cancer/pseudomyxoma Peritoneimentioning

confidence: 93%

Utilization of Interferon in Gynecologic and Breast Cancer

Nomelini

Mardegan

Murta

2007

Clinical medicine. Oncology

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Abstract:The usual treatment of gynecologic cancer has been surgery, chemotherapy and radiotherapy. New therapies are being developed to improve efficacy of treatment. Interferons are inducible secretory glycoproteins that have immunomodulatory, antiviral, anti-angiogenic and anti-proliferative effects. Their potential antitumor effect has been demonstrated in many studies. Some patients obtain benefi cial effects; in other patients the treatment failure can occur. IFNs can modulate the immune response and inhibition of tumor angiogenesis. When any alteration in gene expression occurs, there is modulation of the receptors of other cytokines and enzymes that control cell function. These alterations can infl uence the differentiation, cell proliferation rate and apoptosis. The molecular mechanisms that control apoptotic cell death can be improved through cancer management using IFN in single, combination or adjuvant treatment. Malignant cells generally present defects in programmed cell death and apoptosis. Immunomodulation and angiogenesis inhibition are indirect antitumor mechanisms mediated by apoptosis. With regard to immunomodulation, IFNs can have antitumor effects through increases in cytotoxic T cells, natural killer cells and dendritic cells. Angiogenesis inhibition can result from endothelial cell apoptosis. This factor is important in inhibiting tumor genesis and forming metastases. The aim of this review is to discuss the role of Interferon in the treatment of gynecologic malignancies/breast cancer and mechanisms of action.

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“…Few data are available as for IP second-line carboplatin (CBDCA)-based chemotherapy in epithelial ovarian cancer (26,(38)(39)(40) . A retrospective analysis on four organo-platinum-based salvage IP trials (CDDP 1 etoposide, CDDP 1 cytarabine, CBDCA 1 etoposide, and CBDCA 1 etoposide 1 recombinant human erythropoietin) showed a higher surgically documented response rate for the 17 patients with small-size residual epithelial ovarian cancer receiving CDDP-based IP therapy compared to 19 patients receiving CBDCAbased IP therapy (71% versus 32%, P , 0.05) (26) .…”

Section: Ip Chemotherapy As Salvage Treatment For Patients With Persimentioning

confidence: 99%

Intraperitoneal chemotherapy in the management of patients with advanced epithelial ovarian cancer: a critical review of the literature

Gadducci

Conte

2008

Int J Gynecol Cancer

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The use of intraperitoneal (IP) chemotherapy has been advocated in different settings of patients with ovarian cancer. Cisplatin is the drug of choice because of its high response rate and minimal local toxicity. This treatment can be given to women with small residual disease after second look, with surgically assessed complete response rates of approximately 30%, and with a prolonged survival in small subset of patients. However, the use of IP chemotherapy as consolidation treatment of pathologically complete responders after first-line systemic chemotherapy has not been definitively evaluated in a phase III trial. There is much debate in the literature both for and against the use of IP chemotherapy in the first-line treatment of optimally debulked ovarian cancer patients. The recent Cochrane meta-analyses of eight randomized trials enrolling 1819 patients has shown that first-line IP chemotherapy improves progression-free survival and overall survival of patients with minimal residual disease after initial surgery. However, the potential for catheter-related complications, abdominal pain with infusion, and toxicities needs to be taken into consideration for decision making in each individual woman. Rectosigmoidal surgery can be associated with gross contamination of the operative field, and in this case, the catheter placement should not be performed during primary surgery but should be delayed to 3 weeks later. Patients should be provided with information on the survival and toxicity for both IP and systemic treatments, as well as practical information about the administration of each regimen, so that they may be involved in the decision-making process.

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Intraperitoneal Carboplatin with or without Interferon-α in Advanced Ovarian Cancer Patients with Minimal Residual Disease at Second Look: A Prospective Randomized Trial of 111 Patients

Cited by 31 publications

References 24 publications

Second-look laparotomy for epithelial ovarian cancer: A reappraisal

Second-look laparotomy for epithelial ovarian cancer: A reappraisal

Utilization of Interferon in Gynecologic and Breast Cancer

Intraperitoneal chemotherapy in the management of patients with advanced epithelial ovarian cancer: a critical review of the literature

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