S. Alex Mastroyannis, MD, MSCE, assistant professor, Department of Ob/Gyn-Gynecologic Oncology, University of Colorado School of Medicine, gynecologic oncologist, University of Colorado Cancer Center-Anschutz Medical Campus, discusses the management of gynecologic cancers, such as metastatic or recurrent ovarian and endometrial cancers.

® State of the Science Summit™, Mastroyannis and colleagues from the University of Colorado Cancer Center each gave presentations on topics spanning gynecologic cancer care. At the event, Mastroyannis highlighted recent updates in the field of ovarian cancer, with a specific focus on the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in this histology. HIPEC, as explained by Mastroyannis, is a surgical procedure conducted during ovarian cancer operations. Once the visible cancer has been excised, heated cisplatin chemotherapy, reaching temperatures of approximately 40°C, is introduced into the abdominal cavity before it is sealed. The phase 3 OVHIPEC-1 trial (NCT00426257) investigated the efficacy and safety of the addition of HIPEC to secondary debulking surgery in patients with stage III ovarian cancer. At a median follow-up of 10.1 years, 89.3% of patients who underwent surgery plus HIPEC experienced recurrence, progression, or death from any cause, compared with 92.7% of patients who received surgery alone.

Mastroyannis emphasizes that the key message of his presentation was to share the recent developments in the management of gynecologic cancers, particularly ovarian cancer. Over the past few years, oncologists within this treatment field have made substantial progress for patients, he explains. Traditionally, carboplatin and paclitaxel were considered the standard treatments for most patients with gynecologic cancers, Mastroyannis explains. However, targeted therapies for patients with gynecologic cancers are receiving renewed attention, he notes.

Molecular testing and tailored treatment strategies are significantly extending patients’ progression-free survival and overall survival outcomes, Mastroyannis says. A broad range of effective treatment options are emerging beyond standard chemotherapy, he states. Overall, Mastroyannis concludes that oncologists should identify the most appropriate treatments for each patient.

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S. Alex Mastroyannis, MD, MSCE, discusses the management of gynecologic cancers, such as metastatic or recurrent ovarian and endometrial cancers.


Dr Mastroyannis on the Continued Investigation of Targeted Therapies in Ovarian Cancer

S. Alex Mastroyannis, MD, MSCE, assistant professor, Department of Ob/Gyn-Gynecologic Oncology, University of Colorado School of Medicine, gynecologic oncologist, University of Colorado Cancer Center - Anschutz Medical Campus, discusses the administration and role of hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer, as well as its benefit for patients as seen in the phase 3 OVHIPEC-1 trial (NCT00426257).

HIPEC is a procedure performed during ovarian cancer surgeries, Mastroyannis begins. After removing visible cancer, cisplatin chemotherapy that has been heated to approximately 40°C is administered into the abdomen, which is then closed, Mastroyannis explains. HIPEC is then circulated within the abdomen for 90 minutes, ensuring the peritoneal cavity is exposed to the treatment, he details. Overall, the procedure adds approximately 2 hours to surgery with the goal of targeting any remaining cancer cells and has shown potential benefits in treating patients with ovarian cancer, Mastroyannis says.

The addition of HIPEC to interval cytoreductive surgery in patients with stage III epithelial ovarian cancer was evaluated in the multicenter, open-label, OVHIPEC-1 trial, Mastroyannis reports. In this trial, patients were assigned to receive interval cytoreductive surgery alone, or with HIPEC plus cisplatin. Results showed that the addition of HIPEC to interval cytoreductive surgery increased both recurrence-free survival (RFS) and overall survival (OS) compared with surgery alone without increasing toxicity, he states. Notably, the median OS was 11.8 monthslonger, and median RFS improved by 11.8 months with the HIPEC approach vs surgery alone.

Overall, HIPEC is a 2-hour surgical intervention that can extend patients' lives by nearly a year, Mastroyannis emphasizes. Mastroyannis and his colleagues perform this technique at the University of Colorado Cancer Center, where it has provided substantial benefit to patients.

S. Alex Mastroyannis, MD, MSCE, discusses the administration and role of hyperthermic intraperitoneal chemotherapy in ovarian cancer, as well as its benefit for patients in the phase 3 OVHIPEC-1 trial.
 

S. Alex Mastroyannis, MD, MSCE

Articles

Dr Mastroyannis on the Continued Investigation of Targeted Therapies in Ovarian Cancer

Dr Mastroyannis on the Administration and Utility of HIPEC in Ovarian Cancer