Fujiwara Keiichi, Nagao Shoji, Tan David, Hasegawa Kosei
Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Japan.
Department of Obstetrics and Gynecology, Faculty of Medicine, Okayama University, Okayama, Japan.
Int J Clin Oncol. 2025 Mar;30(3):427-433. doi: 10.1007/s10147-025-02700-w. Epub 2025 Jan 29.
The Intraperitoneal Carboplatin for Ovarian Cancer (iPocc) trial demonstrated that intraperitoneal (IP) administration of carboplatin is more effective than intravenous (IV) administration for advanced ovarian cancer, especially in cases with large residual tumors, challenging previous assumptions that IP chemotherapy is only beneficial for small residual tumors. Additionally, the iPocc trial showed that IP chemotherapy has a comparable safety profile to IV chemotherapy, with the exception of port-related toxicities. This review summarizes the principles, development, and significance of IP chemotherapy and discusses its future potential in light of recent studies. Notably, the iPocc trial, conducted under Japan's new clinical trial regulations, achieving regulatory approval based on investigator-initiated results. The iPocc regimen offers a viable treatment option for patients with advanced ovarian cancer (stages II-IV). However, bevacizumab is recommended for later-line treatments rather than combining it with IP chemotherapy until further trials support such combinations. Future studies are needed to identify biomarkers that predict response to the iPocc regimen. The trial's success underscores the dedication of patients and families who contributed to this groundbreaking research.
卵巢癌腹腔内卡铂治疗（iPocc）试验表明，对于晚期卵巢癌，腹腔内（IP）给予卡铂比静脉内（IV）给药更有效，尤其是在残留肿瘤较大的情况下，这挑战了以往认为IP化疗仅对小残留肿瘤有益的假设。此外，iPocc试验表明，除了与端口相关的毒性外，IP化疗与IV化疗具有相当的安全性。本综述总结了IP化疗的原则、发展和意义，并根据最近的研究讨论了其未来潜力。值得注意的是，iPocc试验是根据日本新的临床试验法规进行的，基于研究者发起的结果获得了监管批准。iPocc方案为晚期卵巢癌（II-IV期）患者提供了一种可行的治疗选择。然而，在进一步试验支持此类联合之前，推荐贝伐单抗用于后续治疗，而非将其与IP化疗联合使用。需要进一步研究以确定预测对iPocc方案反应的生物标志物。该试验的成功凸显了为这项开创性研究做出贡献的患者和家庭的奉献精神。
