Concentration‐Based Short‐Course Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) at Interval Cytoreductive Surgery (iCRS) for Advanced Ovarian Cancer: Final Analysis of Overall Survival in a Phase 2 Trial

Background The optimal regimen for Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) remains controversial. We aim to present long‐term overall survival results from our phase 2 trial evaluating a concentration‐based short‐course regimen for ovarian cancer at the time of interval CytoReductive Surgery (iCRS). Methods This was a multicenter, single‐arm, phase 2 trial including patients with advanced ovarian cancer undergoing iCRS after neoadjuvant chemotherapy (NACT). HIPEC was administered via the closed‐abdomen technique for 30 min at 41°C–43°C, comprising the use of cisplatin (25 mg/L of perfusate/m 2 , total limit 240 mg) alone, or in combination with doxorubicin (15 mg/L, total limit 90 mg). Results Between February 2015 and July 2019, fifteen patients were enrolled and followed for a median of 110.6 months (95% CI, 85.2 – not reached). Median overall survival was 83.9 months (95% CI, 31.3 – not reached), with a 5‐year survival rate of 53.3% (95% CI, 33.2–85.6) and a restricted mean survival time truncated at 5 years of 45·6 months (95% CI, 37.2–54.0). At the time of this analysis, 13.3% were alive without disease, 13.3% remained on systemic therapy, and 73.3% had died. Conclusion Concentration‐based short‐course HIPEC is a feasible and safe regimen for ovarian cancer patients. This approach is associated with favorable long‐term overall survival, highlighting the need for head‐to‐head comparisons of different HIPEC regimens.