Intraperitoneal chemotherapy is appropriate first line therapy for patients with optimally debulked ovarian cancer

The intraperitoneal administration of antineoplastic agents in the front-line treatment of advanced ovarian cancer is a rational strategy, based on anatomic and pharmacokinetic considerations, as well as an understanding of the natural history of the malignancy. Phase 1 and 2 clinical trial data have supported the potential role for this unique method of drug delivery as a safe and effective management approach in this clinical setting. Two randomized phase 3 trials have demonstrated a favorable impact of cisplatin-based front-line intraperitoneal therapy on survival for patients with 'optimal residual' advanced ovarian cancer. However, for several reasons, additional investigative efforts are required to convince oncologists the time, effort and potential toxicity of intraperitoneal therapy justify its routine use as initial therapy of this malignancy.