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Search for Clinical Trials
NCI's PDQ® Cancer Clinical Trials Registry.
Ovarian Cancer Home Page
NCI's gateway for information about ovarian cancer.
Intraperitoneal Therapy for Ovarian Cancer
A collection of links to materials relating to the January 5, 2006, clinical announcement from the National Cancer Institute, concerning evidence in support of intraperitoneal therapy for ovarian cancer.
Highlights from ASCO 2002
A collection of links to material summarizing some of the important clinical trial results announced at the 2002 annual meeting of the American Society of Clinical Oncology (ASCO).
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Intraperitoneal Chemotherapy Shows Promise for Ovarian Cancer
Key Words: intraperitoneal chemotherapy, ovarian cancer. (Definitions of many terms related to cancer can be found in the Cancer.gov Dictionary.)
A new study presented Tuesday, May 21, 2002, at the American Society of Clinical Oncology meeting offers additional evidence that intensive intraperitoneal (IP) therapy after surgery does a better job of slowing down ovarian cancer compared with standard intravenous (IV) therapy. However, IP therapy is also more toxic. [Editor's note: final data from the following study were subsequently published in the Jan. 4, 2006, issue of the New England Journal of Medicine, prompting the National Cancer Institute to issue a clinical announcement encouraging the use of IP chemotherapy in the treatment of advanced ovarian cancer.)
The study by the Gynecologic Oncology Group involved 417 patients with stage III ovarian cancer who had undergone surgery to reduce their tumors to no more than one centimeter in size. Patients were randomly assigned to receive either intravenous (IV) paclitaxel (brand name Taxol®) and IV cisplatin, or IV paclitaxel plus IP cisplatin and IP paclitaxel. In IV therapy, chemotherapy drugs are administered by vein, whereas in IP therapy, the drugs are injected into the peritoneum (lining of the abdomen).
After three years of follow-up, 77.5 percent of patients who received the IP regimen were still alive (159 of 205), compared with 71 percent of patients in the IV group (150 of 211). Patients in the IP group experienced no disease progression for an average of 24 months, compared with 19 months for those who received the standard IV regimen.
However, significantly higher numbers of patients in the IP group experienced adverse effects from the chemotherapy. For example, 46 percent experienced nausea and vomiting (compared with 24 percent of those in the IV group); 31 percent (versus 14 percent) had depressed white blood celll counts; and 11 percent (versus 1 percent) had pain.
It is still too soon to know whether IP therapy will improve overall survival among patients in this study, said principal investigator Deborah Armstrong, M.D., of Johns Hopkins Oncology Center in Baltimore, Md. However, two previous Gynecologic Oncology Group trials have shown an improvement in overall survival in patients with ovarian cancer who were treated with similar IP regimens. In one study (SWOG 8501), the survival advantage was eight months; in the second (GOG 114), five months.
"We eagerly await the data on long term survival," said Edward L. Trimble, M.D., M.P.H., of the National Cancer Institute's Division of Cancer Treatment and Diagnosis. "Should these bear out the improvement in progression-free survival, we will need to determine how best to combine an IP approach with standard therapy."
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