Studies have shown that surgery combined with Intraperitoneal Hyperthermic Chemotherapy (IPHC) can improve survival rates for select patients with peritoneal carcinoma (cancer of the lining of the abdominal cavity) that has spread from colorectal or appendix cancer.
Researchers from Wake Forest University School of Medicine will present findings from two studies on the use of IPHC in treating peritoneal cancer that has spread from these two primary cancer sites at the annual meeting of the Society of Surgical Oncology in Chicago, March 13-16.
John H. Stewart, IV, M.D., assistant professor of surgery, section of surgical oncology, reports March 13 on the results of a study evaluating toxicity when combining surgery and IPHC using oxaliplatin as the chemotherapy agent in patients with peritoneal cancer which originated as colorectal or appendix cancer.
“A large body of literature suggests that oxaliplatin is superior to other chemotherapy agents in killing colorectal cancer cells,” said Stewart. “Further, we have previously demonstrated that the cancer-killing effects of oxaliplatin are increased when the agent is heated during perfusion.”
The purpose of the phase I study was to establish the maximum tolerated dose of oxaliplatin used in IPHC treating colorectal and appendix cancers that have spread to the peritoneum.
Fifteen patients were enrolled in the study at two dose levels, 200 mg/m² and 250 mg/m². At the maximum tolerated dose of 200 mg/m², only two significant toxicities were encountered. More severe toxicities were observed in patients receiving 250 mg/m².
Researchers concluded that IPHC with 200 mg/m² of oxaliplatin is well tolerated and is the maximally tolerated dose for a two-hour chemoperfusion.
“Based on the data from this phase I study, we propose to conduct a larger trial with oxaliplatin dose to study its efficacy in improving outcomes in patients with peritoneal carcinoma,” said Stewart.
On March 14, Perry Shen, M.D. associate professor, section of surgical oncology, will report findings on the use of IPHC in patients with peritoneal cancer and hepatic metastases (HM), or liver cancer that has metastasized from colorectal cancer. The use of IPHC in patients with this presentation is controversial.