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Huang Y, Li C, Zhang X, Zhang M, Ma Y, Qin D, Tang S, Fei W, Qin J. Nanotechnology-integrated ovarian cancer metastasis therapy: Insights from the metastatic mechanisms into administration routes and therapy strategies. Int J Pharm 2023; 636:122827. [PMID: 36925023 DOI: 10.1016/j.ijpharm.2023.122827] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
Ovarian cancer is a kind of malignant tumour which locates in the pelvic cavity without typical clinical symptoms in the early stages. Most patients are diagnosed in the late stage while about 60 % of them have suffered from the cancer cells spreading in the abdominal cavity. The high recurrence rate and mortality seriously damage the reproductive needs and health of women. Although recent advances in therapeutic regimes and other adjuvant therapies improved the overall survival of ovarian cancer, overcoming metastasis has still been a challenge and is necessary for achieving cure of ovarian cancer. To present potential targets and new strategies for curbing the occurrence of ovarian metastasis and the treatment of ovarian cancer after metastasis, the first section of this paper explained the metastatic mechanisms of ovarian cancer comprehensively. Nanomedicine, not limited to drug delivery, offers opportunities for metastatic ovarian cancer therapy. The second section of this paper emphasized the advantages of various administration routes of nanodrugs in metastatic ovarian cancer therapy. Furthermore, the third section of this paper focused on advances in nanotechnology-integrated strategies for targeting metastatic ovarian cancer based on the metastatic mechanisms of ovarian cancer. Finally, the challenges and prospects of nanotherapeutics for ovarian cancer metastasis therapy were evaluated. In general, the greatest emphasis on using nanotechnology-based strategies provides avenues for improving metastatic ovarian cancer outcomes in the future.
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Affiliation(s)
- Yu Huang
- Academy of Chinese Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Chaoqun Li
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Xiao Zhang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Meng Zhang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Yidan Ma
- Department of Pharmacy, Yipeng Medical Care Center, Hangzhou 311225, China
| | - Dongxu Qin
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Sangsang Tang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Weidong Fei
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
| | - Jiale Qin
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
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Comparative Survival Outcomes of Hyperthermic Intraperitoneal Chemotherapy, Intraperitoneal Chemotherapy and Intravenous Chemotherapy for Primary Advanced Ovarian Cancer: A Network Meta-Analysis. J Clin Med 2023; 12:jcm12031111. [PMID: 36769760 PMCID: PMC9917421 DOI: 10.3390/jcm12031111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/16/2023] [Accepted: 01/24/2023] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE We aimed to compare the survival outcomes and adverse events of hyperthermic intraperitoneal chemotherapy (HIPEC), intraperitoneal chemotherapy (IP)and intravenous chemotherapy (IP)for primary advanced ovarian cancer. METHODS PubMed, CENTRAL (Cochrane Central Registry of Controlled Trials), Embase, Web of Science and Scopus were searched using multiple terms for primary advanced ovarian cancer, including randomized controlled trials and comparative studies in both Chinese and English (up to date 15 August 2022). Outcomes include overall survival, progression-free survival and adverse events. The data were pooled and reported as hazard ratio (HRs) with 95% confidence intervals. The Newcastle-Ottawa Scales were used to assess the risk of bias in the included comparative study. The Cochrane Collaboration's Risk of Bias Tool was used for randomized controlled trials. RESULTS In total, 32 studies, including 6347 patients and 8 different platinum-based chemotherapy regimens, were included in this network meta-analysis. Our analysis results showed that HIPEC2 (carboplatin with area under the curve 10) exhibited a statistically significant OS benefit compared to IV, weekly dose-dense chemotherapy and HIPEC1 (cisplatin with 75/100 mg/m2). Intraperitoneal plus intravenous chemotherapy was associated with a statistically significantly better likelihood of overall survival compared to IV. For progression-free survival, our statistical results only suggest a better progression-free survival in ovarian cancer patients treated with HIPEC1 compared with weekly dose-dense chemotherapy. No evidence of difference was observed between the other comparison groups. Compared with the non-HIPEC group, HIPEC may had a higher incidence of electrolyte disturbances (≥grade 3). CONCLUSION Our statistical analysis suggests that the groups receiving HIPEC2 had a better OS than the groups receiving IV, weekly dose-dense chemotherapy and HIPEC1. For PFS, our analysis only showed HIPEC1 is better than IV. Moreover, HIPEC may lead to a higher incidence of electrolyte disturbances (≥grade 3). HIPEC therapy for advanced ovarian cancer is currently controversial.
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Tsonis O, Gkrozou F, Vlachos K, Paschopoulos M, Mitsis MC, Zakynthinakis-Kyriakou N, Boussios S, Pappas-Gogos G. Upfront debulking surgery for high-grade serous ovarian carcinoma: current evidence. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1707. [PMID: 33490219 PMCID: PMC7812243 DOI: 10.21037/atm-20-1620] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
High-grade serous ovarian carcinoma (HGSOC) is a leading cause of mortality among women worldwide. Currently, there is no clear consensus over the regime these patients should receive. The main two options are upfront debulking surgery with adjuvant chemotherapy or neoadjuvant chemotherapy followed by interval debulking surgery (IDS). The former approach is proposed to be accompanied by lower chemoresistance rates but could lead to severe surgical comorbidities and lower quality of life (QoL). Optimizing patient’s selection for upfront debulking surgery might offer higher progression-free and overall survival rates. Further studies need to be conducted in order to elucidate the predictive factors, which are favorable for patients undergoing upfront debulking surgery in cases of high-grade serous ovarian cancer.
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Affiliation(s)
- Orestis Tsonis
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, Ioannina, Greece
| | - Fani Gkrozou
- Department of Obstetrics and Gynaecology, University Hospitals Birmingham, Birmingham, UK
| | - Konstantinos Vlachos
- Department of General Surgery, University Hospital of Ioannina, Ioannina, Greece
| | - Minas Paschopoulos
- Department of Obstetrics and Gynaecology, University Hospital of Ioannina, Ioannina, Greece
| | - Michail C Mitsis
- Department of General Surgery, University Hospital of Ioannina, Ioannina, Greece
| | | | - Stergios Boussios
- Department of Medical Oncology, Medway NHS Foundation Trust, Gillingham, Kent, UK.,AELIA Organization, Thessaloniki, Greece
| | - George Pappas-Gogos
- Department of General Surgery, University Hospital of Ioannina, Ioannina, Greece
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Liu Y, Cao L, Chen W, Wang J, Wang W, Liang Z. Feasibility of neoadjuvant and adjuvant intraperitoneal chemotherapy in patients with advanced epithelial ovarian cancer: A single-center experience. Medicine (Baltimore) 2020; 99:e22100. [PMID: 32899091 PMCID: PMC7478764 DOI: 10.1097/md.0000000000022100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Intraperitoneal (IP) chemotherapy is believed to prolong the survival of patients with advanced ovarian cancer after primary debulking surgery. However, there is little knowledge about IP chemotherapy in the setting of neoadjuvant chemotherapy, and there are contradictory conclusions about adjuvant IP chemotherapy. Here, we evaluated the feasibility of neoadjuvant and adjuvant IP chemotherapy in patients with advanced epithelial ovarian cancer (AEOC).We retrospectively reviewed the data of 114 patients with AEOC who received neoadjuvant chemotherapy followed by laparoscopic conservative interval debulking surgery (NACT + LIDS) in our institution from January 1, 2009 to December 31, 2017.The median overall survival (OS) was 56 months and the median disease-free interval (DFI) was 14 months for the entire study population. Neoadjuvant IP chemotherapy cycles were crucial for the treatment of no gross residual (R0) disease (hazard ratio [HR] = 0.446, 95% confidence interval [CI] = 0.245-0.811), which was independently associated with OS of the entire study population (HR = 9.589, 95% CI = 3.911-23.507). In addition, residual disease and body mass index (BMI) were the prognostic factors for DFI (HR = 6.022, 95% CI = 3.632-9.986; HR = 1.085, 95% CI = 1.012-1.163). However, adjuvant IP cycles along with BMI were the determining factors for DFI in the R0 group (HR = 0.703, 95% CI = 0.525-0.941; HR = 1.130, 95% CI = 1.025-1.247), and were associated with OS in the R0 group (HR = 0.488, 95% CI = 0.289-0.824). The OS and DFI Kaplan-Meier curves stratified by adjuvant IP chemothearpy cycles within the R0 group were statistically significant (P = .024 and P = .033, respectively).Our results showed improvement in patients with AEOC in terms of survival, thus suggesting the feasibility of neoadjuvant and adjuvant IP chemotherapy.
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Baydoun M, Moralès O, Frochot C, Ludovic C, Leroux B, Thecua E, Ziane L, Grabarz A, Kumar A, de Schutter C, Collinet P, Azais H, Mordon S, Delhem N. Photodynamic Therapy Using a New Folate Receptor-Targeted Photosensitizer on Peritoneal Ovarian Cancer Cells Induces the Release of Extracellular Vesicles with Immunoactivating Properties. J Clin Med 2020; 9:jcm9041185. [PMID: 32326210 PMCID: PMC7230754 DOI: 10.3390/jcm9041185] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/11/2020] [Accepted: 04/12/2020] [Indexed: 12/12/2022] Open
Abstract
Often discovered at an advanced stage, ovarian cancer progresses to peritoneal carcinoma, which corresponds to the invasion of the serosa by multiple tumor implants. The current treatment is based on the combination of chemotherapy and tumor cytoreduction surgery. Despite the progress and standardization of surgical techniques combined with effective chemotherapy, post-treatment recurrences affect more than 60% of women in remission. Photodynamic therapy (PDT) has been particularly indicated for the treatment of superficial lesions on large surfaces and appears to be a relevant candidate for the treatment of microscopic intraperitoneal lesions and non-visible lesions. However, the impact of this therapy on immune cells remains unclear. Hence, the objective of this study is to validate the efficacy of a new photosensitizer [pyropheophorbide a-polyethylene glycol-folic acid (PS)] on human ovarian cancer cells and to assess the impact of the secretome of PDT-treated cells on human peripheral blood mononuclear cells (PBMC). We show that PS, upon illumination, can induce cell death of different ovarian tumor cells. Furthermore, PDT using this new PS seems to favor activation of the immune response by inducing the secretion of effective cytokines and inhibiting the pro-inflammatory and immunosuppressive ones, as well as releasing extracellular vesicles (EVs) prone to activating immune cells. Finally, we show that PDT can activate CD4+ and CD8+ T cells, resulting in a potential immunostimulating process. The results of this pilot study therefore indicate that PS-PDT treatment may not only be effective in rapidly and directly destroying target tumor cells but also promote the activation of an effective immune response; notably, by EVs. These data thus open up good prospects for the treatment of micrometastases of intraperitoneal ovarian carcinosis which are currently inoperable.
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Affiliation(s)
- Martha Baydoun
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Olivier Moralès
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- CNRS UMS 3702, Institut de Biologie de Lille, 59 021 Lille, France
| | - Céline Frochot
- LGRGP, UMR-CNRS 7274, University of Lorraine, 54 001 Nancy, France; (C.F.); (C.L.)
| | - Colombeau Ludovic
- LGRGP, UMR-CNRS 7274, University of Lorraine, 54 001 Nancy, France; (C.F.); (C.L.)
| | - Bertrand Leroux
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Elise Thecua
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Laurine Ziane
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Anne Grabarz
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- Unité de Gynécologie-Obstétrique, Hôpital Jeanne de Flandre, 59 000 CHU Lille, France
| | - Abhishek Kumar
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Clémentine de Schutter
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
| | - Pierre Collinet
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- Unité de Gynécologie-Obstétrique, Hôpital Jeanne de Flandre, 59 000 CHU Lille, France
| | - Henri Azais
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- Service de Chirurgie et Cancérologie Gynécologique et Mammaire, Hôpital de la Pitié-Salpêtrière, AP-HP, 75 013 Paris, France
| | - Serge Mordon
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- Correspondence: (S.M.); (N.D.); Tel./Fax: +33-32044-6708 (S.M.); Tel.: +33-3208-71253/1251 (N.D.); Fax: +33-32087-1019 (N.D.)
| | - Nadira Delhem
- Université de Lille, Faculté des Sciences et Technologies, INSERM, CHU-Lille, U1189-ONCO-THAI–Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France; (M.B.); (O.M.); (B.L.); (E.T.); (L.Z.); (A.G.); (A.K.); (C.d.S.); (P.C.); (H.A.)
- Correspondence: (S.M.); (N.D.); Tel./Fax: +33-32044-6708 (S.M.); Tel.: +33-3208-71253/1251 (N.D.); Fax: +33-32087-1019 (N.D.)
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Bixel K, Vetter M, Davidson B, Berchuck A, Cohn D, Copeland L, Fowler JM, Havrilesky L, Lee PS, O'Malley DM, Salani R, Valea F, Alvarez Secord A, Backes F. Intraperitoneal chemotherapy following neoadjuvant chemotherapy and optimal interval tumor reductive surgery for advanced ovarian cancer. Gynecol Oncol 2020; 156:530-534. [PMID: 31937450 DOI: 10.1016/j.ygyno.2019.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/10/2019] [Accepted: 12/16/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Intraperitoneal (IP) chemotherapy following neoadjuvant chemotherapy (NACT) and interval tumor reductive surgery (TRS) for advanced ovarian cancer is feasible, however, the impact on disease outcomes remains unclear. We compare outcomes of patients treated with IP chemotherapy versus intravenous (IV) chemotherapy following NACT and interval TRS. METHODS In this retrospective review, patients with advanced ovarian cancer were included if they received NACT followed by optimal interval TRS between 1/2004 and 4/2017. Patients were excluded if they had an ECOG PS >1, received >6 cycles of NACT or postoperative chemotherapy, and/or received bevacizumab during primary therapy. Primary outcomes were progression free survival (PFS) and overall survival (OS). RESULTS There were 134 patients included in this study, 37 (28%) received IP and 97 (72%) received IV chemotherapy postoperatively. Patients in the IV group were older (median 66.3 vs 59.7 years, p = 0.0039) though there were no differences in BMI, race, BRCA status, stage, or histology. Median PFS was 3 months longer in the IP group (14.5 versus 11.5 months, p = 0.028) however there was no significant difference in OS. On univariate analysis, increasing number of NACT cycles (HR 1.914, 95% CI 1.024-3.497) and residual disease at completion of TRS (HR 1.541, 95% CI 1.042-2.248) were associated with decreased PFS; IP chemotherapy was associated with increased PFS (HR 0.633, 95% CI 0.414-0.944). These associations remained on multivariate analysis. Toxicity was comparable between the groups. CONCLUSIONS IP after NACT and optimal interval TRS was associated with in improved PFS compared to IV chemotherapy without significant differences in toxicity.
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Affiliation(s)
- K Bixel
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America.
| | - M Vetter
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - B Davidson
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America; Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States of America
| | - A Berchuck
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America; Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States of America
| | - D Cohn
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - L Copeland
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - J M Fowler
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - L Havrilesky
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America; Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States of America
| | - P S Lee
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America; Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States of America
| | - D M O'Malley
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - R Salani
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - F Valea
- Division of Gynecologic Oncology, Virginia Tech Carilion School of Medicine, Roanoke, VA, United States of America
| | - A Alvarez Secord
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America; Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States of America
| | - F Backes
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
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Bartels HC, Rogers AC, McSharry V, McVey R, Walsh T, O'Brien D, Boyd WD, Brennan DJ. A meta-analysis of morbidity and mortality in primary cytoreductive surgery compared to neoadjuvant chemotherapy in advanced ovarian malignancy. Gynecol Oncol 2019; 154:622-630. [DOI: 10.1016/j.ygyno.2019.07.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 01/27/2023]
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Horvath P, Königsrainer A. [Surgical treatment of peritoneal metastases from gynecological primary tumors]. Chirurg 2018; 89:678-686. [PMID: 29974140 DOI: 10.1007/s00104-018-0679-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The principle of surgical treatment of peritoneal metastases of ovarian cancer in the primary as well as in the recurrent disease setting includes macroscopic complete cytoreductive surgery. The addition of intraperitoneal chemotherapy after cytoreduction is currently not part of the standard treatment. OBJECTIVE Data on intraperitoneal chemotherapy for treatment of peritoneal metastases of ovarian cancer are presented focusing on overall and progression-free survival and on morbidity and mortality rates. METHOD PubMed search including the following terms: ovarian cancer, peritoneal metastases, cytoreduction and HIPEC. RESULTS Randomized-controlled and non-randomized controlled trials showed that intraperitoneal chemotherapy after maximum cytoreductive surgery results in a survival benefit regarding overall and progression-free survival for primary as well as recurrent disease. Addition of HIPEC does not impact on the initiation of postoperative systemic chemotherapy. CONCLUSION Macroscopic complete cytoreduction is the most important prognostic factor. The addition of intraperitoneal chemotherapy for the treatment of peritoneal metastases of ovarian cancer showed promising results but so far it is not accepted as a part of a multimodal treatment concept.
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Affiliation(s)
- P Horvath
- Abteilung für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland
| | - A Königsrainer
- Abteilung für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland.
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Lee J, Curtin JP, Muggia FM, Pothuri B, Boyd LR, Blank SV. Timing is everything: intraperitoneal chemotherapy after primary or interval debulking surgery for advanced ovarian cancer. Cancer Chemother Pharmacol 2018; 82:55-63. [PMID: 29704010 DOI: 10.1007/s00280-018-3591-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/23/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the outcomes of intraperitoneal chemotherapy (IP) compared with those of intravenous chemotherapy (IV) in patients with advanced ovarian cancer after neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) or primary debulking surgery (PDS). METHODS Patients with advanced epithelial ovarian carcinoma treated with PDS or NACT and IDS from 2006 to 2015 were identified. Comparative statistics were used to evaluate covariates, and survival rates were calculated using the Kaplan-Meier method and compared with log-rank tests. RESULTS Sixty-six patients received NACT followed by IDS with residual disease of ≤ 1 cm; 42 of these patients (63.6%) received IP therapy; and 24 patients (36.3%) had IV therapy only after IDS. The median progression-free survival (PFS) was 16.0 months in the IP group and 13.5 months in the IV group (p = 0.13). The estimated median overall survival (OS) was 64.0 months with IP and 50.0 months with IV (p = 0.44). During the same study period, 149 patients underwent optimal PDS after which 93 patients (62.4%) received IP and 56 patients (37.6%) were given IV chemotherapy. Patients after IP demonstrated improved survival outcomes when compared to patients after IV therapy. The median PFS was 28.0 months after IP and 16.5 months after IV (p = 0.0006), and the median OS was not reached for IP and 50.0 months after IV (p < 0.0001). CONCLUSIONS Although IP chemotherapy after PDS is associated with improved survival, IP therapy after NACT and IDS, despite high rates of completion, may not have the same degree of survival advantage over IV therapy.
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Affiliation(s)
- Jessica Lee
- Division of Gynecologic Oncology, New York University School of Medicine, 240 East 38th Street, New York, NY, USA.
| | - John P Curtin
- Division of Gynecologic Oncology, New York University School of Medicine, 240 East 38th Street, New York, NY, USA
| | - Franco M Muggia
- Division of Medical Oncology, New York University School of Medicine, 160 East 34th Street, New York, NY, USA
| | - Bhavana Pothuri
- Division of Gynecologic Oncology, New York University School of Medicine, 240 East 38th Street, New York, NY, USA
| | - Leslie R Boyd
- Division of Gynecologic Oncology, New York University School of Medicine, 240 East 38th Street, New York, NY, USA
| | - Stephanie V Blank
- Division of Gynecologic Oncology, Icahn School of Medicine at Mount Sinai, 1176 Fifth Avenue, New York, NY, USA
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Schumann C, Chan S, Millar JA, Bortnyak Y, Carey K, Fedchyk A, Wong L, Korzun T, Moses AS, Lorenz A, Shea D, Taratula O, Khalimonchuk O, Taratula O. Intraperitoneal nanotherapy for metastatic ovarian cancer based on siRNA-mediated suppression of DJ-1 protein combined with a low dose of cisplatin. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2018; 14:1395-1405. [PMID: 29635082 DOI: 10.1016/j.nano.2018.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/12/2018] [Accepted: 03/20/2018] [Indexed: 12/11/2022]
Abstract
Herein, we report an efficient combinatorial therapy for metastatic ovarian cancer based on siRNA-mediated suppression of DJ-1 protein combined with a low dose of cisplatin. DJ-1 protein modulates, either directly or indirectly, different oncogenic pathways that support and promote survival, growth, and invasion of ovarian cancer cells. To evaluate the potential of this novel therapy, we have engineered a cancer-targeted nanoplatform and validated that DJ-1 siRNA delivered by this nanoplatform after intraperitoneal injection efficiently downregulates the DJ-1 protein in metastatic ovarian cancer tumors and ascites. In vivo experiments revealed that DJ-1 siRNA monotherapy outperformed cisplatin alone by inhibiting tumor growth and increasing survival of mice with metastatic ovarian cancer. Finally, three cycles of siRNA-mediated DJ-1 therapy in combination with a low dose of cisplatin completely eradicated ovarian cancer tumors from the mice, and there was no cancer recurrence detected for the duration of the study, which lasted 35 weeks.
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Affiliation(s)
- Canan Schumann
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Stephanie Chan
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Jess A Millar
- Fairborz Maseeh Department of Mathematics and Statistics, Portland State University, OR, USA
| | - Yuliya Bortnyak
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Katherine Carey
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Alex Fedchyk
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Leon Wong
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Tetiana Korzun
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Abraham S Moses
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Anna Lorenz
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Delany Shea
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Olena Taratula
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA
| | - Oleh Khalimonchuk
- Department of Biochemistry and Redox Biology Center, University of Nebraska, Lincoln, NE, USA; Fred & Pamela Buffett Cancer Center, Omaha, NE, USA
| | - Oleh Taratula
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Portland, OR, USA.
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