Dr. Lee on Data Regarding HIPEC in mCRC

Byrne Lee, MD, chief, Upper GI and Mixed Tumor Surgery Service, associate clinical professor of surgical oncology, Department of Surgery, and surgical oncologist, City of Hope, discusses data regarding the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with metastatic colorectal cancer (mCRC).

At the 2019 Gastrointestinal Cancers Symposium, data from the multicenter phase III COLOPEC trial were presented. Investigators evaluated the use of HIPEC as an adjuvant treatment for patients with high-risk CRC; these were patients with perforated colon cancers or T4 colon cancers, says Lee. The goal was to determine whether or not the use of intraperitoneal chemotherapy and cytoreductive surgery would improve survival in these patients. However, data failed to show that the use of HIPEC provided a benefit to patients.

Currently, HIPEC regimens that are used in the United States differ from those that were evaluated in recent trials. In both the PRODIGE 7 and COLOPEC trials, investigators gave oxaliplatin for an infusion time of 30 minutes. In the United States, however, the majority of practices use mitomycin C over a perfusion time of 90 to 120 minutes. That additional perfusion time may help a subset of patients, says Lee. However, more data will need to be gathered before HIPEC becomes part of routine practice, he concludes.