Novel Cancer Treatment Combines Surgery with Direct Immune Therapy Delivery

A completed French clinical trial explored an innovative treatment approach for advanced ovarian cancer by combining surgical tumor removal, heated chemotherapy, and direct immune therapy delivery. The phase I/II study, conducted by leading peritoneal cancer specialists in Lyon, enrolled 22 patients with advanced ovarian carcinoma.

The treatment protocol involved extensive debulking surgery to remove visible tumors, followed by hyperthermic intraperitoneal chemotherapy (HIPEC), where heated chemotherapy drugs are circulated directly in the abdominal cavity. Patients then received nivolumab, an immune checkpoint inhibitor, delivered directly into the peritoneal cavity rather than through traditional intravenous infusion.

The rationale behind this approach centers on the theory that surgery and heated chemotherapy increase tumor antigen expression and mutational load, potentially making cancer cells more recognizable to the immune system. Direct intraperitoneal delivery of nivolumab was hypothesized to enhance immune response, as recent research suggests the peritoneum functions as a lymphoid organ capable of producing stronger immune responses when immunotherapy is administered locally.

The primary objective was to assess the safety and feasibility of this dose-escalation protocol. The study was completed in October 2022 after three years of patient enrollment and follow-up. This research represents an important step in developing more targeted cancer treatments that leverage the body's immune system while minimizing systemic side effects through localized drug delivery approaches.