Andrew Epstein, MD
“This is a very important study,” said ASCO expert Andrew Epstein, MD, of Memorial Sloan Kettering Cancer Center (MSK), New York. “Hyperthermic intraperitoneal chemotherapy is used in the United States and elsewhere, even though the benefits are unknown. This study shows there are no benefits, and there are detriments.”
Dr. Epstein continued: “Hyperthermic intraperitoneal chemotherapy is used without good evidence, and level 1 evidence from this randomized controlled trial shows that 60 days postop, patients who received it had more complications. There are proponents of this approach and skeptics, but their views are usually based on personal experience or small, single-arm, noncontrolled studies.”
For Dr. Epstein, the take-home message is that less is certainly more in this case. “We need high-quality randomized data such as these to demonstrate which treatments are helpful and which are not. We should not use hyperthermic intraperitoneal chemotherapy off study,” he noted. “Our natural inclination as doctors is to try to do whatever we can to help patients deal with the myriad complexities of cancer therapy, but we need to determine through research like this what is truly valuable,” he emphasized. ■
DISCLOSURE: Dr. Esptein reported no conflicts of interest.
With a growing emphasis on value in cancer care, some types of resource-intensive therapies may need to be reconsidered. One such treatment may be hyperthermic intraperitoneal chemotherapy, which showed no benefit during surgery for colorectal cancer confined to the peritoneum in the PRODIGE 7...