Intraperitoneal catheter outcomes in a phase III trial of intravenous versus intraperitoneal chemotherapy in optimal stage III ovarian and primary peritoneal cancer: A Gynecologic Oncology Group Study

Proceedings of a GOG workshop on intraperitoneal therapy for ovarian cancer

“…IP therapy was administered to 16% of patients randomized to IP therapy who had a left colon or rectosigmoid colon resection (compared to 4% of patients who did not, p = 0.012). No relationship was found between the timing of catheter insertion and subsequent failure to complete IP therapy [23].…”

“…Most patients in both arms received six courses of assigned or other chemotherapy treatment (90% of patients randomized to IV therapy compared to 83% of patients randomized to IP therapy). Primary reasons for discontinuation of IP therapy (n=119) included catheter complications (n=40, 33%), toxicity (n=31, 26%), and non-catheter issues such as patient refusal (n=19, 16%), noncatheter related infection (n=7, 6%), and other reasons (n=11, 9%) [23]. IP therapy was administered to 16% of patients randomized to IP therapy who had a left colon or rectosigmoid colon resection (compared to 4% of patients who did not, p = 0.012).…”

“…Six patients were treated either after secondary debulking (four patients) or after recurrence from prior IP consolidation based on cytology (two patients). Progression occurred at 15,16,23,38, and 86 weeks, with one patient in remission at 54+ weeks. CA-125 decreased by 20 to 78% in four of four patients (100%) with an abnormal marker baseline.…”

“…The Clinical Announcement was timed to coincide with the publication of the primary manuscript in the New England Journal of Medicine [12] and the secondary manuscript, on catheter outcomes, in Gynecologic Oncology [23].…”

Cancer of the ovary, fallopian tube, and peritoneum

“…Although intraperitoneal chemotherapy has been shown to be associated with improved progression-free survival and overall survival in selected patients with optimally debulked Stage III ovarian cancer, it is not widely used outside the USA because of concerns regarding increased toxicity and catheter-related problems, and the benefits are still debated [58][59][60][61][62]. The GOG 172 trial compared intravenous paclitaxel plus cisplatin with intravenous paclitaxel plus intraperitoneal cisplatin and paclitaxel in patients with Stage III ovarian or peritoneal carcinoma, with no residual disease greater than 1 cm in diameter [60].…”