Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®)–Health Professional Version

OVARIAN, FALLOPIAN TUBE, AND PRIMARY PERITONEAL CANCER

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Changes to This Summary (07/13/2018)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information About Ovarian Epithelial Cancer, Fallopian Tube Cancer (FTC), and Primary Peritoneal Cancer (PPC)

Added the Risk Factors for Ovarian (Epithelial) Cancer module.

Advanced-Stage Ovarian Epithelial Cancer, Fallopian Tube Cancer (FTC), and Primary Peritoneal Cancer (PPC) Treatment

Revised text of a standard treatment option to state that intraperitoneal therapy has also been used after chemotherapy and surgery.

Added text to state that hyperthermic intraperitoneal chemotherapy (HIPEC) has been used for peritoneal carcinomatosis from various origins, mostly for chemotherapy-resistant disease and after extensive cytoreductive debulking surgery. Added that experience with HIPEC spans more than two decades after initial publications that have since been summarized (cited Koopman et al. as reference 44).

Added text about a Dutch study that published final results of a phase III open-label trial performed in eight hospitals on 245 patients with newly diagnosed ovarian cancer who were at least stable after receiving three cycles of carboplatin and paclitaxel 175 mg/m2, both of which were given intravenously (IV) every 3 weeks (cited van Driel et al. as reference 45). Also added that randomization took place at the time of surgery, patients were assigned to undergo either cytoreductive surgery without HIPEC or cytoreductive surgery with HIPEC, and all patients subsequently received three additional cycles of IV chemotherapy. Also provided median follow-up data, described the HIPEC perfusion, and explained the use of sodium thiosulfate (cited Howell et al. as reference 46).

Added text about the Dutch study to include statistical data from the median follow-up at 4.7 years and an intention-to-treat analysis, the median recurrence-free survival time for the HIPEC group, the number of deaths, the median overall survival in each group, and the patient characteristics for the surgery group and the HIPEC group.

Added text to state that in the institutions that have experience preforming HIPEC, adverse events were comparable in the two groups and provided statistical data from each group to show the differences in occurrences of ileus, fever, thromboembolic events, electrolyte changes and neuropathy, with both groups also receiving IV chemotherapy. Added that the use of sodium thiosulfate most likely accounts for the favorable safety profile vis-à-vis cisplatin, which was given as part of HIPEC in a published phase I trial (cited Zivanovic et al. as reference 47). Concluded that HIPEC should be considered an option for patients who receive neoadjuvant therapy if they have access to a surgical team who has experience performing HIPEC.

Recurrent or Persistent Ovarian Epithelial Cancer, FTC, and PPC Treatment

Added text to state that rucaparib was assessed as maintenance therapy after response to platinum therapy in the ARIEL 3 study, a randomized double-blind, placebo-controlled phase III trial (cited Coleman et al. as reference 25). Added eligibility criteria and treatment allocation for 375 patients receiving rucaparib and 189 patients receiving placebo, with progression-free survival (PFS) as the primary endpoint using a step-down procedure for three determined, nested treatment cohorts, which included patients known to have deleterious germline or somatic BRCA mutations, patients with homologous recombination deficiencies, and the intention-to-treat population and provided PFS statistical data for each cohort.

Added text to state that treatment-emergent adverse events of grade 3 or higher in the rucaparib group versus the placebo group consisted primarily of anemia and increased alanine or aspartate aminotransferases.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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