Advances in the Management of CRC - Episode 5

Discerning HIPEC


Wells A. Messersmith, MD, FACP: The European HIPEC study was a very high-impact trial that was presented at ASCO 2018, and we await full details of the study. The take-home message was that chemotherapy in a cytoreductive procedure didn’t really seem to add benefit to just surgery alone. HIPEC is a fairly controversial area, and there’s a lot of geographical variation in terms of what heated intraperitoneal chemotherapy even means, what the contribution of temperature is, how high the temperature should be, what exactly the chemotherapy agents should be, and what its role is in terms of what it’s really adding to this surgery. What this trial has indicated is that the chemotherapy does not add much at all to the surgery.

And so, it will be interesting to see how centers that use HIPEC—and it tends to be done in fairly specialized centers—react to this data. I would commend the Europeans on getting this done, because trials in the United States studying HIPEC don’t tend to accrue well. We have not been able to successfully carry out these trials, because people have either tended to believe in it or not. I look forward to further data coming out of that trial in terms of who might benefit from including chemotherapy regarding those surgical patients.

Transcript Edited for Clarity