Point: Intraperitoneal Chemotherapy in the Management of Ovarian Cancer

Author:
Maurie MarkmanUniversity of Texas M. D. Anderson Cancer Center, Houston, Texas

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Volume/Issue:
Volume 2: Issue 6
Online Publication Date:
Nov 2004
DOI:
https://doi.org/10.6004/jnccn.2004.0045
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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.

Address correspondence to Maurie Markman, MD, Vice President for Clinical Research (Mail Box #121), University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030. E-mail: mmarkman@mdanderson.org
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  • 1

    Weisberger AS, Levine B, Storaasli JP. Use of nitrogen mustard in treatment of serous effusions of neoplastic origin. J Am Med Assoc 1955;159:1704–1707.

    • Search Google Scholar
    • Export Citation
  • 2

    Dedrick RL, Myers CE, Bungay PM et al.. Pharmacokinetic rationale for peritoneal drug administration in the treatment of ovarian cancer. Cancer Treat Rep 1978;62:1–9.

    • Search Google Scholar
    • Export Citation
  • 3

    Alberts DS, Young L, Mason N et al.. In vitro evaluation of anticancer drugs against ovarian cancer at concentrations achievable by intraperitoneal administration. Semin Oncol 1985;12(Suppl 4):38–42.

    • Search Google Scholar
    • Export Citation
  • 4

    Markman M. Intraperitoneal therapy for treatment of malignant disease principally confined to the peritoneal cavity. Crit Rev Oncol Hematol 1993;14:15–28.

    • Search Google Scholar
    • Export Citation
  • 5

    West GW, Weichselbau R, Little JB. Limited penetration of methotrexate into human osteosarcoma spheroids as a proposed model for solid tumor resistance to adjuvant chemotherapy. Cancer Res 1980;40:3665–3668.

    • Search Google Scholar
    • Export Citation
  • 6

    Durand RE. Flow cytometry studies of intracellular adriamycin in multicell spheroids in vitro. Cancer Res 1981;41:3495–3498.

  • 7

    Ozols RF, Locker GY, Doroshow JH et al.. Pharmacokinetics of adriamycin and tissue penetration in murine ovarian cancer. Cancer Res 1979;39:3209–3214.

    • Search Google Scholar
    • Export Citation
  • 8

    Nederman T, Carlsson J. Penetration and binding of vinblastine and 5-fluorouracil in cellular spheroids. Cancer Chemother Pharmacol 1984;13:131–135.

    • Search Google Scholar
    • Export Citation
  • 9

    Los G, Mutsaers PHA, van der Vijgh WJF et al.. Direct diffusion of cis-diamminedichloroplatinum(II) in intraperitoneal rat tumors after intraperitoneal chemotherapy: A comparison with systemic chemotherapy. Cancer Res 1989:49:3380–3384.

    • Search Google Scholar
    • Export Citation
  • 10

    Howell SB, Pfeifle CE, Wung WE et al.. Intraperitoneal cisplatin with systemic thiosulfate protection. Ann Intern Med 1982;97:845–851.

  • 11

    Casper ES, Kelsen DP, Alcock NW et al.. Ip cisplatin in patients with malignant ascites: Pharmacokinetic evaluation and comparison with the IV route. Cancer Treat Rep 1983;67:325–338.

    • Search Google Scholar
    • Export Citation
  • 12

    DeGregorio MW, Lum BL, Holleran WM et al.. Preliminary observations of intraperitoneal carboplatin pharmacokinetics during a phase I study of the Northern California Oncology Group. Cancer Chemother Pharmacol 1986;18:235–238.

    • Search Google Scholar
    • Export Citation
  • 13

    Elferink F, van der Vijgh WJF, ten Bokkel Huinink WW et al.. Pharmacokinetics of carboplatin after intraperitoneal administration. Cancer Chemother Pharmacol 1988;21:57–60.

    • Search Google Scholar
    • Export Citation
  • 14

    Markman M, Rowinsky E, Hakes T et al.. Phase 1 trial of intraperitoneal taxol: A Gynecologic Oncology Group study. J Clin Oncol 1992;10:1485–1491.

    • Search Google Scholar
    • Export Citation
  • 15

    Ozols RF, Young RC, Speyer JL et al.. Phase 1 and pharmacological studies of adriamycin administered intraperitoneally to patients with ovarian cancer. Cancer Res 1982;42:4265–4269.

    • Search Google Scholar
    • Export Citation
  • 16

    Francis P, Rowinsky E, Schneider J et al.. Phase 1 feasibility and pharmacologic study of weekly intraperitoneal paclitaxel: A Gynecologic Oncology Group pilot study. J Clin Oncol 1995;13:2961–2967.

    • Search Google Scholar
    • Export Citation
  • 17

    Markman M. Intraperitoneal antineoplastic drug delivery: Rationale and results. The Lancet Oncology 2003;4:277–283.

  • 18

    Markman M, Reichman B, Hakes T et al.. Responses to second-line cisplatin-based intraperitoneal therapy in ovarian cancer: influence of a prior response to intravenous cisplatin. J Clin Oncol 1991; 9:1801–1805.

    • Search Google Scholar
    • Export Citation
  • 19

    Markman M, Berek JS, Blessing JA et al.. Characteristics of patients with small-volume residual ovarian cancer unresponsive to cisplatin-based IP chemotherapy: Lessons learned from a Gynecologic Oncology Group phase II trial of IP cisplatin and recombinant alpha-interferon. Gynecol Oncol 1992;45:3–8.

    • Search Google Scholar
    • Export Citation
  • 20

    Markman M, Blessing JA, Major F et al.. Salvage intraperitoneal therapy of ovarian cancer employing cisplatin and etoposide: A Gynecologic Oncology Group study. Gynecol Oncol 1993;50:191–195.

    • Search Google Scholar
    • Export Citation
  • 21

    Markman M, Brady MF, Spirtos NM et al.. Phase II trial of intraperitoneal paclitaxel in carcinoma of the ovary, tube, and peritoneum: A Gynecologic Oncology Group study. J Clin Oncol 1998;16:2620–2624.

    • Search Google Scholar
    • Export Citation
  • 22

    Markman M. Intraperitoneal chemotherapy. Crit Rev Oncol Hematol 1999;31:239–246.

  • 23

    Braly PS, Berek JS, Blessing JA et al.. Intraperitoneal administration of cisplatin and 5-fluorouracil in residual ovarian cancer: A phase II Gynecologic Oncology Group trial. Gynecol Oncol 1995;56:164–168.

    • Search Google Scholar
    • Export Citation
  • 24

    Markman M, George M, Hakes T et al.. Phase 2 trial of intraperitoneal mitoxantrone in the management of refractory ovarian carcinoma. J Clin Oncol 1990;8:146–150.

    • Search Google Scholar
    • Export Citation
  • 25

    Berek JS, Markman M, Stonebraker B et al.. Intraperitoneal interferon-α in residual ovarian carcinoma: a phase II Gynecologic Oncology Group study. Gynecol Oncol 1999;75:10–14.

    • Search Google Scholar
    • Export Citation
  • 26

    Pujade-Lauraine E, Guastalla J-P, Colombo N et al.. Intraperitoneal recombinant interferon gamma in ovarian cancer patients with residual disease at second-look laparotomy. J Clin Oncol 1996;14:343–350.

    • Search Google Scholar
    • Export Citation
  • 27

    Edwards RP, Gooding W, Lembersky BC et al.. Comparison of toxicity and survival following intraperitoneal recombinant interleukin-2 for persistent ovarian cancer after platinum: twenty-four-hour versus 7-day infusion. J Clin Oncol 1997;15:3399–3407.

    • Search Google Scholar
    • Export Citation
  • 28

    Pfeiffer P, Bennedbaek O, Bertelsen K. Intraperitoneal carboplatin in the treatment of minimal residual ovarian cancer. Gynecol Oncol 1990;36:306–311.

    • Search Google Scholar
    • Export Citation
  • 29

    Speyer JL, Beller U, Colombo N et al.. Intraperitoneal carboplatin: Favorable results in women with minimal residual ovarian cancer after cisplatin therapy. J Clin Oncol 1990;8:1335–1341.

    • Search Google Scholar
    • Export Citation
  • 30

    Howell SB, Zimm S, Markman M et al.. Long term survival of advanced refractory ovarian carcinoma patients with small-volume disease treated with intraperitoneal chemotherapy. J Clin Oncol 1987; 5:1607–1612.

    • Search Google Scholar
    • Export Citation
  • 31

    Markman M, Reichman B, Hakes T et al.. Impact on survival of surgically-defined favorable responses to salvage intraperitoneal chemotherapy in small volume residual ovarian cancer. J Clin Oncol 1992; 10:1479–1484.

    • Search Google Scholar
    • Export Citation
  • 32

    Piver MS, Recio FO, Baker TR et al.. Evaluation of survival after second-line intraperitoneal cisplatin-based chemotherapy for advanced ovarian cancer. Cancer 1994;73:1693–1698.

    • Search Google Scholar
    • Export Citation
  • 33

    Barakat R, Sabbatini P, Bhaskaran D et al.. Intraperitoneal chemotherapy for ovarian carcinoma: results of long-term follow-up in 411 patients. J Clin Oncol 2002;20:694–698.

    • Search Google Scholar
    • Export Citation
  • 34

    Alberts DS, Liu PY, Hannigan EV et al.. Intraperitoneal cisplatin plus intravenous cyclophosphamide versus intravenous cisplatin plus intravenous cyclophosphamide for stage III ovarian cancer. N Engl J Med 1996;335:1950–1955.

    • Search Google Scholar
    • Export Citation
  • 35

    Markman M, Bundy BN, Alberts DS et al.. Randomized phase III trial of standard-dose intravenous cisplatin plus paclitaxel versus moderately high dose carboplatin followed by intravenous paclitaxel and intraperitoneal cisplatin in small-volume stage III ovarian carcinoma: an intergroup study of the Gynecologic Oncology Group, Southwestern Oncology Group, and Eastern Cooperative Oncology Group. J Clin Oncol 2001;19:1001–1007.

    • Search Google Scholar
    • Export Citation
  • 36

    Shapiro F, Schneider J, Markman M et al.. High-intensity intravenous cyclophosphamide and cisplatin, interim surgical debulking, and intraperitoneal cisplatin in advanced ovarian carcinoma: A pilot trial with ten-year follow-up. Gynecol Oncol 1997;67:39–45.

    • Search Google Scholar
    • Export Citation
  • 37

    Armstrong DK, Bundy BN, Baergen R et al.. Randomized phase III study of intravenous paclitaxel and cisplatin versus IV paclitaxel, intraperitoneal (IP) cisplatin and IP paclitaxel in optimal stage III epithelial ovarian cancer: a Gynecologic Oncology Group trial (Abstr). Proc Am Soc Clin Oncol 2002;21:201a.

    • Search Google Scholar
    • Export Citation
Copyright:
Copyright © 2004 by the National Comprehensive Cancer Network 2004
Page Numbers:
6
Article Category:
Research Article
Received:
15 Mar 2004
Accepted:
06 Aug 2004
Print Publication Date:
01 Nov 2004
Online Publication Date:
Nov 2004
Keywords:
Ovarian cancer; cisplatin; carboplatin; intraperitoneal chemotherapy
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