No Subgroups Benefit From HIPEC/CRS in Colorectal Peritoneal Metastasis

When asked about specific patient subgroups that experienced enhanced benefits or risks with the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreduction surgery (CRS) vs HIPEC alone in the treatment of colorectal cancer with peritoneal metastasis, Muhammad Talha Waheed, MD, stated that he and his fellow investigators did not find any enhanced benefits.

Waheed, a postdoctoral research fellow at City of Hope Comprehensive Cancer Center in Duarte, California, spoke with CancerNetwork® about a study he presented at the 2025 Society of Surgical Oncology Annual Meeting (SSO) in which HIPEC plus CRS showed no added survival benefits vs CRS alone in the indicated patient population.¹

He acknowledged that the randomized, phase 3 PRODIGE-7 trial (NCT00769405) did show that a subgroup of patients who had a peritoneal carcinomatosis index score of 11 to 15 had a variable benefit with HIPEC, although his study did not find any subgroups that showed enhanced benefit.²

As far as risks go, Waheed was not able to comment on the differing complication rates of the 2 treatments because they are still being analyzed and are planned to be shared in a paper.

Transcript:

PRODIGE-7 did a stratified subgroup analysis where they found that patients who had a peritoneal carcinomatosis index or PCI score of 11 to 15 had a variable benefit if they underwent CRS [with] HIPEC. That is used to justify the continued use of HIPEC for [patients with] colorectal cancer with peritoneal metastasis. We had to do a similar analysis for our paper.…Unfortunately, we did not find any benefit for any of the subgroups in our paper and our study. To answer the question [of whether any specific patients had enhanced benefits or risks]: not really. For the enhanced risk, at this point, I’m not able to comment on the complication rates between these 2 treatments, but that is something in the plans, and we will report that in the paper.

References:

1. Waheed MT, Paz IB, Lwin T, et al. Impact of systematic discontinuation of mitomycin C (MMC) HIPEC for colorectal peritoneal metastasis (CRCPM) on oncologic outcomes at an NCI cancer center. Presented at SSO 2025; March 27-29, 2025; Tampa, FL.
2. Quénet F, Elias D, Roca L, et al. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22(2):256-266. doi:10.1016/S1470-2045(20)30599-4