Work

Homologous recombination status drives disease-free survival in patients with advanced ovarian cancer undergoing hyperthermic intraperitoneal chemotherapy at the time of interval debulking surgery

Year: 2025

Type: article

Abstract: Objective Describe surgical outcomes of patients undergoing HIPEC with cisplatin (C) alone or cisplatin/paclitaxel (CP), compared to interval debulking surgery (IDS) without HIPEC, and stratify disease-free survival (DFS) by treatment and homologous recombination (HR) status. Methods Retrospective chart review of patients with advanced ovarian cancer undergoing IDS with and without HIPEC between 2018–2024. DFS was compared using a log rank test. Cox proportional hazards model was used to test association between treatment group and recurrence. Results 74 patients were included: 20 in no HIPEC, 28 in HIPEC-C, and 26 in HIPEC-CP groups. Duration of surgery was shortest in no HIPEC group (159 ± 64 min vs HIPEC-C 377 ± 54 min vs HIPEC-CP 400 ± 48 min, p < 0.0001). Post-operatively, there was no difference in days to return of bowel function (p = 0.17) or Grade II-IV complications (p = 0.39). HIPEC-C group had longest time to discharge (4.5 ± 1.2 post-operative days vs no HIPEC 3.8 ± 1.9 vs HIPEC-CP 3.6 ± 0.9, p = 0.002). Twenty-nine (39.2 %) patients were HR deficient (HRD). Median DFS did not differ between treatment groups (no HIPEC 17.0 months vs HIPEC-C 13.87 months vs HIPEC-CP 19.25 months, p = 0.853). Median DFS was higher in HRD vs HRP (HR proficient) patients (40.5 months vs 11.4 months, HR 0.32 (95 % CI: 0.19–0.57, p = 0.0001). Conclusions Addition of paclitaxel to cisplatin at the time of IDS with HIPEC had no effect on peri -operative morbidity. No differences in DFS were seen between treatment groups. HRD group had a significantly longer DFS, when compared to HRP. Tumor genetics and HR status likely drive response to treatment in advanced ovarian cancer.

Source: Gynecologic Oncology Reports

DOI: 10.1016/j.gore.2025.101981

Authors: Khrystyna Levytska, SeungYong Han, Allison E. Axtell, Malaika W. Amneus, Brandon Ing, Scott E. Lentz

Institutions: Cedars-Sinai Medical Center, Kaiser Permanente, Los Angeles Medical Center

Language: English

Topic: Ovarian cancer diagnosis and treatment

Subfield: Reproductive Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $930