Intraperitoneal cis-platinum as salvage therapy for refractory epithelial ovarian cancer

Hacker, Neville F.; Berek, Jonathan S.; Pretorius, R G; Zuckerman, Jesse; Eisenkop, Scott M.; Lagasse, Leo D.

doi:10.1016/0090-8258(85)90182-9

Cited by 13 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hacker eta/. (17) reported subcutaneous (s.c.) recurrence in one of six patients with a positive second-look laparotomy which progressed after intraperitoneal cisplatin salvage chemotherapy. Others have usually not mentioned the site of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Extraperitoneal metastases after intraperitoneal chemotherapy of ovarian cancer patients with a negative second-look laparotomy

Menczer

Ben‐Baruch

Rizel

et al. 1993

Int J Gynecol Cancer

View full text Add to dashboard Cite

The site of the first detectable recurrence was recorded in 17 consecutive stage II-IV ovarian carcinoma patients who, after a negative second-look laparotomy, received intraperitoneal chemotherapy with cisplatin and thiosulfate kidney protection. Although the progression-free interval and survival were favorable, 11 patients eventually had a recurrence and in six (54.5%) of these it was extraperitoneal. Brain metastases were detected in three patients. The appearance of extraperitoneal metastases is not always ominous.

show abstract

Section: Discussionmentioning

confidence: 99%

Extraperitoneal metastases after intraperitoneal chemotherapy of ovarian cancer patients with a negative second-look laparotomy

Menczer

Ben‐Baruch

Rizel

et al. 1993

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

“…Subsequently, phase II studies using intraperitoneal single-agent platinum or platinum-based combinations have demonstrated that approximately 50% of patients with residual small-volume (0.5 cm) disease after front-line intravenous cisplatin will experience further objective regression of their residual disease with this regional dose-intensive therapy. Up to 60% of patients who had a partial response to prior intravenous platinum therapy experienced a further response to intraperitoneal platinum and on average 20% of the patients achieved surgically complete response (30). This suggests that a 10-to 20-fold increase in cisplatin concentration can overcome moderate resistance to this drug.…”

Section: Does Dose Intensity Improve Outcome?mentioning

confidence: 97%

Physiologic and Pathologic Drug Resistance in Ovarian Carcinoma: A Hypothesis Based on a Clonal Progression Model

et al. 1998

View full text Add to dashboard Cite

Conventional models for successful chemotherapy suggest that early-stage ovarian cancer should be more responsive to cytotoxic drugs than advanced disease, that multiple drugs will prove more efficacious than single agents and that more intensive chemotherapy will prove superior to conventional doses. The purpose of numerous clinical studies has been to test these predictions and the results often fall short of the expectations. In trials to date, adjuvant chemotherapy for high-risk, early-stage ovarian cancer has provided only a modest, equivocal increase in disease-free survival. Combination chemotherapy produces higher response rates but this has not consistently resulted in prolonged survival. Dose intensification with high-dose chemotherapy increases rate of response further, but most responses are of short duration. The objective of this review is to integrate clinical and molecular biological observations into a novel model of drug resistance. We hypothesize that drug sensitivity is an acquired characteristic of neoplastic cells, and that there are two broad cellular forms of resistance to cytotoxic drugs. 'Physiological drug resistance' is a cellular state when drug sensitivity of cancer cells is similar to that of the corresponding normal tissue. This form of drug resistance can precede the acquisition of drug sensitivity and may be predominant in the early stages of neoplastic progression. A distinct, 'pathological drug resistance' can reappear later during tumor progression or during chemotherapy as a result of increased detoxification, upregulation of repair pathways or defective apoptosis. Tumors are formed of heterogeneous cell populations and in terms of drug sensitivity three distinct cell types may be present: drug-sensitive, physiologically drug-resistant and pathologically drug-resistant. Clinical response to chemotherapy is determined by the relative contribution of these different cell populations to the total cellular mass. Depending on the predominant type of surviving population, distinct patterns of clinical failure may develop that require different treatment strategies for optimal management. For chemosensitive cells that survived insufficient chemotherapy, consolidation with further, perhaps, high-dose chemotherapy is a rational option. For pathologically drug-resistant cells, pharmacological manipulation of drug resistance, and signaling pathways in combination with chemotherapy could be exploited. For physiologically drug-resistant cells, non-chemotherapy-based, 'chemopreventive' strategies to arrest tumor progression may prove beneficial.

show abstract

“…Cisplatin (CDDP) is the drug of choice for IP chemotherapy of epithelial ovarian cancer because of its high response rate and minimal local toxicity, and in the past two decades, several phase II trials have shown that IP CDDP-based chemotherapy could achieve objective responses, including surgically documented complete responses, in patients with persistent disease after first-line systemic chemotherapy, with potential (although not proven) improvement of their clinical outcome (19,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36) (Tables 2, 3).…”

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

View full text Add to dashboard Cite

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.

show abstract

Intraperitoneal cis-platinum as salvage therapy for refractory epithelial ovarian cancer

Cited by 13 publications

References 0 publications

Extraperitoneal metastases after intraperitoneal chemotherapy of ovarian cancer patients with a negative second-look laparotomy

Extraperitoneal metastases after intraperitoneal chemotherapy of ovarian cancer patients with a negative second-look laparotomy

Physiologic and Pathologic Drug Resistance in Ovarian Carcinoma: A Hypothesis Based on a Clonal Progression Model

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

Contact Info

Product

Resources

About