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Brief Title: Cytoreductive Surgery and HIPEC in First or Secondary Platinum-resistant Recurrent Ovarian Epithelial Cancer
Official Title: Assessment of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in First or Secondary Platinum-resistant Recurrent Ovarian Epithelial Cancer
Study ID: NCT03220932
Brief Summary: With 4,600 new cases in France in 2012, ovarian cancer is the seventh most common cancer in women and the fourth cause of mortality by cancer. Despite a high response rate to initial treatment, most patients will relapse within 2 years. No standard treatment has yet been established for patients with recurrent ovarian cancer. Most patients with such recurrences are currently treated with new combinations of systemic chemotherapy. A repeated laparotomy with complete cytoreduction is also an option that several authors have used to obtain median survival rates of more than 30 months. Twenty five percent of patients experiencing relapse present with platinum-resistant recurrence, occurring less than 6 months after chemotherapy completion. Recently, Pujade et al. showed that adding bevacizumab to chemotherapy significantly improves progression-free survival (PFS) in this subgroup of patients with poor prognoses (16.6 months versus 13.3 months in women treated with chemotherapy alone). Three case control studies have compared systemic chemotherapy and CRS (Cytoreduction Surgery) alone versus CRS plus HIPEC in patients with recurrent disease. They showed significantly improved results with the addition of HIPEC. In the French registry that included 474 patients with recurrence and peritoneal carcinomatosis, the median PFS was 13.8 months for platinum-resistant patients and 13 months for platinum-sensitive patients. Our hypothesis is that surgery would reduce the tumor burden and consequently the number of platinum-resistant tumor clones and that HIPEC would control the microscopic residual disease by increasing the tumor cell cytotoxicity. We assume that adding a locoregional treatment to an "Aurelia-like" systemic treatment would improve the PFS. We aim to assess the benefit of adding surgery and HIPEC to the treatment of first or second platinum-resistant recurrence compared to chemotherapy + bevacizumab.
Detailed Description:
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: FEMALE
Healthy Volunteers: No
Centre Hospitalier Universitaire Jean Minjoz, Besançon, , France
Centre Hospitalier Universitaire Jean Minjoz, Besançon, , France
Centre Oscar Lambret, Lille, , France
CHRU Claude Huriez, Lille, , France
Centre Léon Bérard, Lyon, , France
Centre Léon Bérard, Lyon, , France
Institut du Cancer de Montpellier, Montpellier, , France
Institut du Cancer de Montpellier, Montpellier, , France
Centre Hospitalier Universitaire L'Archet II, Nice, , France
Centre Hospitalier Universitaire L'Archet II, Nice, , France
Centre Hospitalier Universitaire L'Archet II, Nice, , France
Hôpital Européen Georges Pompidou - APHP, Paris, , France
Centre Hospitalier Lyon Sud, Pierre-benite, , France
Centre Hospitalier Lyon Sud, Pierre-Bénite, , France
Centre Hospitalier Universitaire de Poitiers, Poitiers, , France
Centre Hospitalier Universitaire de St Etienne, Saint-priest-en-jarez, , France
Centre Hospitalier Universitaire de St Etienne, Saint-Priest-en-Jarez, , France
Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, , France
Centre Hospitalier Universitaire Hautepierre, Strasbourg, , France
Centre Hospitalier Universitaire Hautepierre, Strasbourg, , France
Centre Hospitalier Universitaire Hautepierre, Strasbourg, , France
Institut de Cancérologie de Lorraine - Alexis Vautrin, Vandœuvre-lès-Nancy, , France