237O - Effects of neoadjuvant hyperthermic intraperitoneal chemotherapy on chemotherapy response score and recurrence for high-grade serous ovarian cancer patients with advanced disease

Background

For ovarian cancer patients with unresectable disease, neoadjuvant chemotherapy (NACT) plus interval debulking surgery (IDS) is an important treatment option. Previously, we reported that hyperthermic intraperitoneal chemotherapy (HIPEC) could be used in the neoadjuvant setting. In this retrospective cohort study, we sought to investigate whether the use of NHIPEC could improve patient outcomes compared with traditional intravenous NACT for patients with high-grade serous ovarian cancer (HGSOC).

Methods

HGSOC patients who received NACT-IDS between 2012 to 2019 were identified. Tumor response to NACT was evaluated with the chemotherapy response score (CRS) system. The effects of NACT modality on survival outcomes were assessed using the Kaplan-Meier method and multivariable regression analysis.

Results

Of the 106 included patients, 38 (35.8%) received NHIPEC (one cycle) + intravenous NACT (two cycles), while 68 (64.2%) received intravenous NACT (three cycles). The use of NHIPEC was independently associated with an increased likelihood of CRS3 [odd ratio = 6.99; 95% confidence interval (CI), 1.95 to 25.01, P = 0.003]. The median progression-free survival (PFS) was 21 months for patients treated with NHIPEC + intravenous NACT versus 16 months for patients treated with intravenous NACT [hazard ratio (HR) 0.57; 95% CI, 0.33 to 0.99, P = 0.048). Median overall survival (OS) was not reached, and no association was found between NACT types and OS (HR 1.41; 95% CI, 0.49 to 4.06, P = 0.526). NHIPEC was not associated with an increased risk of adverse events.

Conclusions

The application of the NHIPEC was associated with an improved tumor response and PFS. It could be considered as a treatment option for HGSOC patients who are not suitable for upfront cytoreduction.

Clinical trial identification

Editorial acknowledgement