Update on clinical trials in colorectal cancer peritoneal metastasis

Abstract

Background/purpose: Peritoneal metastases (PM) arising from colorectal cancer (CRC) can be treated using cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in select patients.

Objective: To review clinical trials that were reported during the 10th International Congress on Peritoneal Surface Malignancies and dedicated to the treatment of CRC-PM.

Methods: Ten clinical trials were presented at the 10th Peritoneal Surface Oncology Group International (PSOGI) meeting in November 2016 in Washington DC. The flow charts of the studies were identified on ClinicalTrials.gov. Additional data were collected regarding the author’s presentations during the meeting.

Results: Four trials (Dutch, French, Italian and Spanish) focussed on a preventive strategy to decrease the rate of CRC-PM. Inclusions were closed for the French study – ProphyloCHIP. Two trials were specific, with one American study dedicated to appendix cancer and one French study testing phase 1 intraperitoneal oxaliplatin drug administration. CRS and HIPEC for PM were compared in others trials with different intraperitoneal treatments without hyperthermia or with no intraperitoneal treatment or with intravenous chemotherapy. Inclusions were closed for the French study – PRODIGE 7.

Conclusion: The number of recruiting trials evaluating CRS and HIPEC in the prevention or therapy of CRC PM is increasing, and these have been activated in the US and different European countries. It could be postulated that in less than a decade, clinical results will change the common practice and validate the impact of PSOGI on cancer treatment.