Current recommendation of the French Haute Autorité de Santé (HAS) on HIPEC (June 2021)
Aug 28, 2021
In June 2021, the Haute Autorité de Santé (HAS), the French Health Technology Assessment Authority, has published the following recommendation on HIPEC.
"With regard to the evaluation of the efficacy and safety of HIPEC, whether or not associated with prior cytoreduction, as well as the definition of its validated indications and its non-validated indications relating to clinical research, the HAS considers first of all that the currently validated indications of HIPEC are:
1) curative treatment of peritoneal carcinomatosis secondary to FIGO III stage ovarian cancer, which cannot be operated straight away in the context of interval surgery (OVHIPEC study population);
with the following HIPEC protocol: cisplatin 100 mg / m² distributed according to the OVHIPEC study protocol at a rate of 50 mg / m² at the start of the procedure, 25 mg / m² at 30 minutes and 25 mg / m² at 60 minutes, for a total duration of 90 minutes at 40 ° C, systematically associated with nephroprotection by hydration and sodium thiosulphate in IV;
2) curative treatment of primary peritoneal carcinomas / rare cancers (peritoneal mesothelioma and pseudomyxoma);
- for peritoneal mesothelioma with Cisplatin, doxorubicin and mitomycin-based HIPEC protocols used in combination or based on cisplatin and mitomycin alone;
- for pseudomyxoma with mitomycin alone or oxaliplatin alone HIPEC protocols.
The HAS then considers that the other indications studied have not yet been validated and come under clinical research; they are the following:
a) curative treatment of peritoneal carcinomatosis of colorectal origin (first cancer and recurrence);
b) preventive treatment of peritoneal carcinomatosis of colorectal origin (first cancer and recurrence);
c) curative treatment of peritoneal carcinomatosis secondary to recurrent ovarian cancer;
d) initial curative treatment of peritoneal carcinomatosis secondary to ovarian cancer;
e) curative treatment of peritoneal carcinomatosis secondary to gastric cancer (first cancer and recurrence).
Indeed, for these indications, the data from the literature analyzed are not in favor of the use of HIPEC, as are the majority of the experts of the working group and of the stakeholders. The HAS recommends that clinical research continue in these indications."
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