Combo Rx May Boost Ovarian Cancer Outcomes, But Too Few Get It: Study

Therapy involves dosing chemo directly into the abdomen, researchers explain

By Robert Preidt

Monday, August 3, 2015

MONDAY, Aug. 3, 2015 (HealthDay News) -- Chemotherapy delivered directly into the abdomen significantly improves survival among women with advanced ovarian cancer, a new study finds.

However, fewer than half of U.S. patients who could benefit from this treatment -- called intraperitoneal chemotherapy -- are receiving it, according to Dana-Farber/Brigham and Women's Cancer Center researchers.

The investigators studied whether a combination of intraperitoneal (IP) and intravenous (IV) chemotherapy was as effective in clinical practice as in a clinical trial involving women who'd had surgery for stage III ovarian cancer.

The researchers examined the medical records of more than 800 women who were treated for stage III ovarian cancer between 2003 and 2012, and were eligible for IP/IV combination therapy.

According to the study, 81 percent of women who received the dual therapy were alive three years after treatment, compared with 71 percent of those who received IV chemotherapy alone. However, only 41 percent of the patients who were deemed to be suitable candidates actually received the dual therapy, the team reported.

The investigators also found that the side effects of the dual therapy were less severe than those reported in the clinical trial.

"This is the first study to show that IP/IV chemotherapy improves survival in the real world, outside of a clinical trial," first author Dr. Alexi Wright, of Dana-Farber Cancer Institute in Boston, said in an institute news release.

"Unfortunately, fewer than half of women who qualify for IP/IV chemotherapy received the treatment. This suggests that increasing access to IP/IV chemotherapy may improve ovarian cancer patients' survival," she added.

Two experts not connected to the study agreed that the combo treatment may work better, but side effects are often an issue.

"The National Cancer Center Network guidelines do recommend this treatment option for patients with stage II or higher disease," said Dr. Eva Chalas, chief of gynecologic oncology at Winthrop-University Hospital in Mineola, N.Y.

"However, this treatment is more poorly tolerated by patients, and is associated with more side effects," she added, and the new study pointed that out, as well.

Still, "patients should be aware that this therapy represents a very effective option and should remain motivated to proceed, if it is recommended to them by their gynecologic oncologist," Chalas said.

Dr. Kit Cheng is a medical oncologist at North Shore-LIJ Cancer Institute in Lake Success, N.Y. She believes that future clinical trials "will shed more light to the best treatment to improve the survival of our [ovarian cancer] patients with the least amount of side effects."

The study was published in the Aug. 3 issue of the Journal of Clinical Oncology.

SOURCES: Kit Cheng, M.D., medical oncologist, North Shore-LIJ Cancer Institute, Lake Success, N.Y.; Eva Chalas, M.D., chief, gynecologic oncology and director, clinical cancer services, Winthrop-University Hospital, Mineola, N.Y.; Dana-Farber Cancer Institute, news release, Aug. 3, 2015

HealthDay