The OJC S4E6: HIPEC Hits a Wall, Beyond Curative vs Palliative + ctDNA After Metastasectomy

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Negative trials matter. In this episode, the Oncology Journal Club team discuss research that challenges established practice, alongside thought-provoking papers exploring how we communicate treatment goals in the era of immunotherapy and precision oncology.

Professor Chris Jackson reviews the PERISCOPE II trial, showing that adding gastrectomy, cytoreductive surgery and HIPEC to systemic therapy does not improve survival for patients with gastric cancer and limited peritoneal metastases, while substantially increasing treatment-related morbidity.

Dr Kate Clarke examines the NeoSUMMIT-01 trial, which provides further evidence supporting perioperative PD-1 inhibition alongside chemotherapy for gastric and gastro-oesophageal cancers, with encouraging improvements in event-free and overall survival.

Professor Craig Underhill leads a discussion on a JAMA Oncology viewpoint questioning whether the traditional "curative" versus "palliative" treatment framework remains fit for purpose in modern oncology, particularly as immunotherapy and targeted therapies create new patterns of long-term survival.

The team also explores:

• Smoking cessation programmes that improve outcomes for patients with cancer 
• New ctDNA data following colorectal liver metastasectomy 
• Steroids to reduce morphine-induced nausea and vomiting 
• Highlights from the ASCO Breakthrough meeting 
• The Lancet Oncology Commission on the global cancer workforce crisis 
• Tumour-agnostic therapies and the challenges of equitable implementation 
• Five-year follow-up from TOPAZ-1 in advanced biliary tract cancer 
• A comprehensive review of recent advances in prostate cancer 

The Oncology Journal Club Podcast is hosted by Professor Craig Underhill, Dr Kate Clarke and Professor Chris Jackson, and proudly produced by The Oncology Network.

Visit oncologynetwork.com.au for Show Notes, to send us Voice Notes and more information.