Point: Intraperitoneal chemotherapy in the management of ovarian cancer.
Both preclinical considerations and results of phase I safety and pharmacokinetic studies provided support for the argument that intraperitoneal antineoplastic drug delivery should be a rational approach to the management of ovarian cancer. Subsequently conducted phase II trials exploring regional treatment revealed surgically documented objective responses when the approach was employed as a second-line therapy. Recently, the results of three randomized phase III trials have shown that the use of primary cisplatin-based intraperitoneal therapy leads to superior survival compared with intravenous cisplatin-based treatment in patients with small-volume residual advanced ovarian cancer after initial surgical cytoreduction. Further exploration of this unique management strategy is indicated to develop an optimal approach that maintains the demonstrated enhanced efficacy while reducing the toxicity (principally because of cisplatin) of treatment.
University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. mmarkman@mdanderson.org
Maurie
M
Markman
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology; D017321:Clinical Trials, Phase I as Topic / Q000379:methods / Q000639:trends; D017322:Clinical Trials, Phase II as Topic / Q000379:methods / Q000639:trends; D017326:Clinical Trials, Phase III as Topic / Q000379:methods / Q000639:trends; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000639:trends
D000970:Antineoplastic Agents