Goal: to assess toxicity, quality of life, and progression-free survival (PFS) in patients with advanced ovarian cancer who underwent neoadjuvant chemotherapy (NAC) followed by CRS and HIPEC with carboplatin. This phase 2 trial enrolled patients with advanced epithelial ovarian cancer (stage IIIC or IVA) who were not good candidates for primary CRS. Patients underwent CRS with HIPEC (carboplatin 800 mg/m2 for 90 minutes) after undergoing 3-6 cycles of NAC plus an intravenous carboplatin doublet.

Adverse events, quality of life (QOL), and illness progression were tracked throughout the course of at least a year of observation. Prior to CRS, as well as at 6 weeks, 3 months, and 6 months after the procedure, QOL was evaluated using the Functional Assessment of Cancer Therapy-Ovarian (FACT-O) instruments. There were a total of 20 participants. These 20 patients had HIPEC, and all of them were treated satisfactorily, with no deaths occurring during the procedure. Anemia (59%) was the most prevalent, followed by thrombocytopenia (29%) and hypokalemia (24%). About 12 patients (70.6% of the total) developed a grade 3 or 4 toxicity. FACT-O, NTX, and AD scores did not significantly alter between pre- and post-operative assessments at 6 weeks, 3 months, and 6 months.

In 9 patients, or 45%, the disease has returned. In this group, the median time to first evidence of disease is 11.2 months (2.5–23.7 months). Incorporating HIPEC with carboplatin into interval CRS was generally well-received by the patient community. The most common unwanted effect was myelosuppression. No negative effects on quality of life measures were observed after CRS with HIPEC. More research in the form of a larger clinical study is needed to determine the effectiveness of this regimen.

Source: sciencedirect.com/science/article/abs/pii/S0090825822005698