BETHESDA, Maryland-In a clinical announcement, the National Cancer Institute (NCI), supported by six professional societies and advocacy groups, has urged physicians to use a combination of intravenous (IV) and intraperitoneal (IP) chemotherapy to treat women with advanced ovarian cancer. In the announcement, the first NCI has issued since 1999, the institute said the two techniques used together extend overall survival for advanced ovarian cancer patients by about 1 year.
The NCI announcement noted that eight trials have evaluated the use of chemotherapy delivered into the abdomen for ovarian cancer and that "together, these trials show a significant improvement in survival for women with advanced ovarian cancer."
The standard therapy for stage III ovarian cancer has been surgical removal of the tumor, followed by six to eight courses of IV chemotherapy given every 3 weeks with a platinum drug, usually cisplatin or carboplatin, and a taxane, either pac-litaxel or docetaxel (Taxotere).
NCI now recommends that women with advanced disease who successfully undergo surgery receive a combination of IV and IP chemotherapy. "IP chemotherapy allows higher doses and more frequent administration of drugs, and it appears to be more effective in killing cancer cells in the peritoneal cavity, where ovarian cancer is likely to spread or recur first," the Institute said.
The new recommendation has the backing of the Gynecologic Oncology Group (GOG), Society of Gynecologic Oncologists, Oncology Nursing Society, Society of Gynecologic Nurse Oncolo-gists, Gynecologic Cancer Foundation, and Ovarian Cancer National Alliance.
The statement's release coincided with the publication of results from a large clinical trial (GOG-172) conducted by medical oncologist Deborah Armstrong, MD, of the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, and her colleagues. Their findings appeared in the January 5, 2006, issue of the New England Journal of Medicine (354:34-43, 2006).
Prejudice Against IP Therapy