21P - Cisplatin in NIPEC or HIPEC?

Abstract

Background: Eliminating minimal residual disease in patients with advanced ovarian cancer (AOC) is necessary to prevent recurrencies and could be achieved with hyperthermic intraperitoneal chemoperfusion (HIPEC). Cisplatin comprises the majority of HIPEC regimens due to its known synergic efficacy with hyperthermia. However, emerging report are impugning its role. Our goal was to compare the survival of rats treated with cisplatin by hyperthermic and normothermic intraperitoneal chemoperfusion (HIPEC and NIPEC) and to evaluate, whether the outcome of HIPEC would depend on its opened (oHIPEC) or closed (cHIPEC) delivery. Methods: A rodent model of ascitic ovarian cancer was used. 1*107 tumor cells were inoculated i.p. 48 hours prior to the treatment to 48 female Wistar rats. As indicated by our previous research, this time limit of tumor progression reflects the biological pattern of optimally debulked AOC in women. Each 12 rats were randomized into four groups to receive either cisplatin at a maximum tolerated dose of 20 mg/kg in NIPEC, cHIPEC, and oHIPEC or i.p. 20 mg/kg saline as a control without treatment. Results: The mean survival in the untreated control was 31.8 days. Cisplatin in NIPEC increased the mean survival by 22 days (P = 0.0007), while in cHIPEC and oHIPEC by 19.9 (P = 0.003) and 31.5 (P = 0.003) days, respectively. Cisplatin in oHIPEC was shown to be the most effective combination. The differences between NIPEC and cHIPEC with cisplatin were not statistically significant. Conclusions: Our results prompt that NIPEC with cisplatin might be just as effective as cHIPEC in increasing survival in AOC. Legal entity responsible for the study: Vladimir Bespalov. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.