Multinational phase 3 trial of hyperthermic intraperitoneal chemotherapy for recurrent ovarian cancer

Hyperthermic intraperitoneal chemotherapy (HIPEC) at interval cytoreductive surgery (CRS) for epithelial ovarian cancer (EOC) improves overall survival but its role in recurrent disease is uncertain. The phase 3 CHIPOR trial, at 31 centers in four countries evaluated HIPEC during surgery for recurrent EOC. After six cycles of platinum-based chemotherapy (and optional bevacizumab), patients amenable to complete CRS were randomized to receive HIPEC or not receive HIPEC during CRS. The primary endpoint was overall survival. Median overall survival was 54.3 months in the HIPEC group versus 45.8 months in the no-HIPEC group (sHR 0.73; p=0.024). Grade 3 or worse adverse events within 60 days after surgery occurred in 49% of the patients in the HIPEC group and 27% of patients in the no-HIPEC group. The authors conclude that adding HIPEC to CRS after response to platinum-based chemotherapy at first EOC recurrence significantly improved overall survival.