📍HIPECT4-HIPEC profiláctico en cáncer de colon localmente avanzado (pT4)
academic.oup.com/bjsopen/art…
📊Fase III RCT (n=184)-17 centros en España
🩺HIPEC (mitomicina C) tras cirugía oncológica completa
↓ recidiva locoregional/peritoneal
🧵(1/2)
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🚨 Another packed week across tumor types!
🔗 oncoalert.m-pages.com/nhMpwe…
From KROCUS in KRAS G12C to VIKTORIA-1, BULLSEYE, HIPECT4 and emerging bispecifics in myeloma…signals spanning precision, resistance and escalation strategies!
Oncology doesn’t move in leaps…it moves in layers of evidence 🧠 @OncoAlert
Apr 2
The OncoAlert🚨Newsletter Covering March 26-April 2 2026
REGISTER TO GET IT 👉 buff.ly/7Jlzp0V or OncoAlert360.com
🫁 #LungCancer
• KROCUS (fulzerasib cetuximab, 1L KRAS G12C)
• ALK squamous/adenosquamous NSCLC on alectinib
• Molecular profiling across 82,000 NSCLC patients
🎀 #BreastCancer
• VIKTORIA-1 (gedatolisib fulvestrant ± palbo, PIK3CA WT)
• SERD resistance & luminal lineage loss
• PREDICT ctDNA vs pCR in neoadjuvant HER2 /TNBC
🎯 #ProstateCancer: BULLSEYE (177Lu-PSMA-617 in oligo-HSPC) — 25 vs 5 months PFS
💧 #BladderCancer Advances in localized bladder cancer (Nat Rev Clin Oncol)
🔬 #ColorectalCancer : HIPECT4 — HIPEC in pT4 colon cancer (final data)
🔴 #GynOnc Topical hr-HPV therapy & CIN prevention — systematic review
🩸 #MultipleMyeloma WVT078 WHG626 (BCMA×CD3 bispecific GSI)
@GlopesMd @bmassutis @UmbertoMalapel1 @g_mountzios @BRicciutiMD @DrChoueiri
@neerajaiims @jillfeldman4 @matteolambe @aftimosp @E_de_Azambuja @hoperugo @stolaney1 @JaniceTNBCmets @apolo_andrea @PGrivasMDPhD @amerseburger @sonpavde @drenriquegrande @tompowles1 @nataliagandur @cdanicas @brian_rini @CathyEngMD @agz_eriksson @womenofteal #ELCC26 #EBCC15
#OncoAlertAF
@FernandoOnco @ElisaAgostinett @to_be_elizabeth @realbowtiedoc @Erman_Akkus
@MarioBalsaMD @UOzkerim @DrRishabhOnco @Onco_Cifu88
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#HIPECT4 long term results.
As local PI, I included, operated and followed all patients from my centre (2nd highest recruiting in Spain).
Mitomycin C–based #HIPEC ↓ peritoneal recurrence, no OS/DFS benefit.
Patient selection & endpoints remain key.
Efficacy and safety of intraoperative hyperthermic intraperitoneal chemotherapy for locally advanced colorectal cancer (HIPECT4): final analysis of randomized clinical trial
➡️doi.org/10.1093/bjsopen/zrag…
The long-term outcome analysis of the HIPECT4 trial including 184 patients demonstrated that using mitomycin C-based HIPEC reduced peritoneal recurrence in patients with locally advanced colon cancer without increasing toxicity. However, there was no difference in overall survival and disease-free survival.
👏👏👏@alarjosan-Sánchez , Alberto Gutiérrez-Calvo , Juan J Segura-Sampedro , Rafael Morales , Estibalitz Pérez-Viejo , Vanessa Concepción-Martín , Susana Sánchez-García , Alfonso García-Fadrique , Isabel Prieto-Nieto , Lana Bijelic , Juan Torres-Melero , Maria Ramirez-Faraco , Arancha Prada-Villaverde , Joaquin Carrasco-Campos , Manuel Artiles-Armas , Pedro Villarejo-Campos , Gloria Ortega-Pérez , Enrique Boldo-Roda , Juan M Sánchez-Hidalgo , Angela Casado-Adam , Lidia Rodríguez-Ortiz , Blanca Rufian-Andújar , Enrique Aranda , Maria T Cano-Osuna , Cesar Díaz-López , Antonio Romero-Ruiz , Maria Carmen Vazquez-Borrego , Sebastian Rufián-Peña
#SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery #colorectalsurgery #colorectalcancer @FightCRC
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Efficacy and safety of intraoperative hyperthermic intraperitoneal chemotherapy for locally advanced colorectal cancer (HIPECT4): final analysis of randomized clinical trial
➡️doi.org/10.1093/bjsopen/zrag…
The long-term outcome analysis of the HIPECT4 trial including 184 patients demonstrated that using mitomycin C-based HIPEC reduced peritoneal recurrence in patients with locally advanced colon cancer without increasing toxicity. However, there was no difference in overall survival and disease-free survival.
👏👏👏@alarjosan-Sánchez , Alberto Gutiérrez-Calvo , Juan J Segura-Sampedro , Rafael Morales , Estibalitz Pérez-Viejo , Vanessa Concepción-Martín , Susana Sánchez-García , Alfonso García-Fadrique , Isabel Prieto-Nieto , Lana Bijelic , Juan Torres-Melero , Maria Ramirez-Faraco , Arancha Prada-Villaverde , Joaquin Carrasco-Campos , Manuel Artiles-Armas , Pedro Villarejo-Campos , Gloria Ortega-Pérez , Enrique Boldo-Roda , Juan M Sánchez-Hidalgo , Angela Casado-Adam , Lidia Rodríguez-Ortiz , Blanca Rufian-Andújar , Enrique Aranda , Maria T Cano-Osuna , Cesar Díaz-López , Antonio Romero-Ruiz , Maria Carmen Vazquez-Borrego , Sebastian Rufián-Peña
#SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery #colorectalsurgery #colorectalcancer @FightCRC
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Apr 2
The OncoAlert🚨Newsletter Covering March 26-April 2 2026
REGISTER TO GET IT 👉 buff.ly/7Jlzp0V or OncoAlert360.com
🫁 #LungCancer
• KROCUS (fulzerasib cetuximab, 1L KRAS G12C)
• ALK squamous/adenosquamous NSCLC on alectinib
• Molecular profiling across 82,000 NSCLC patients
🎀 #BreastCancer
• VIKTORIA-1 (gedatolisib fulvestrant ± palbo, PIK3CA WT)
• SERD resistance & luminal lineage loss
• PREDICT ctDNA vs pCR in neoadjuvant HER2 /TNBC
🎯 #ProstateCancer: BULLSEYE (177Lu-PSMA-617 in oligo-HSPC) — 25 vs 5 months PFS
💧 #BladderCancer Advances in localized bladder cancer (Nat Rev Clin Oncol)
🔬 #ColorectalCancer : HIPECT4 — HIPEC in pT4 colon cancer (final data)
🔴 #GynOnc Topical hr-HPV therapy & CIN prevention — systematic review
🩸 #MultipleMyeloma WVT078 WHG626 (BCMA×CD3 bispecific GSI)
@GlopesMd @bmassutis @UmbertoMalapel1 @g_mountzios @BRicciutiMD @DrChoueiri
@neerajaiims @jillfeldman4 @matteolambe @aftimosp @E_de_Azambuja @hoperugo @stolaney1 @JaniceTNBCmets @apolo_andrea @PGrivasMDPhD @amerseburger @sonpavde @drenriquegrande @tompowles1 @nataliagandur @cdanicas @brian_rini @CathyEngMD @agz_eriksson @womenofteal #ELCC26 #EBCC15
#OncoAlertAF
@FernandoOnco @ElisaAgostinett @to_be_elizabeth @realbowtiedoc @Erman_Akkus
@MarioBalsaMD @UOzkerim @DrRishabhOnco @Onco_Cifu88
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Mar 31
HIPEC finally shows a signal in T4 colon cancer.
But not where you expect.
It reduces peritoneal relapse…
Yet DFS and OS don’t improve.
Here’s HIPECT4 final analysis 👇
🧪 Trial
Resectable cT4N0-2M0 colon cancer
n = 184 randomized
⚔️ Arms
🔹 Surgery adjuvant chemo
🔹 Surgery HIPEC (mitomycin C 30 mg/m², 60 min) adjuvant chemo 
📊 Primary endpoint
36-month locoregional control
🔥 Key result
HIPEC improved peritoneal control:
HR 0.19 (95% CI 0.04-0.86), P=0.031 
❗ But the reality check
No significant difference in:
• DFS
• OS 
🎯 Where benefit was strongest
• Definitive pT4: HR 0.08, P=0.017
• Per-protocol (received chemo): HR 0.18, P=0.028 
🧠 What changed biologically?
Less peritoneal relapse
More systemic pattern of recurrence
No added toxicity 
💡 Takeaway
This is NOT a survival-changing trial.
But it is a pattern-changing trial.
👉 HIPEC may matter in selected high-risk T4 patients
👉 Not ready for universal adoption
🔖 Save this before your next tumor board
📖 Full paper in comment ⬇️
#OncoTwitter #MedTwitter #ColorectalCancer #SurgicalOncology @OncoAlert @myesmo @esmo_open @asco @BJSurgery
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Excellent share of the HIPECT4 Phase III RCT! 🔥 HIPEC clearly improves peritoneal control (HR 0.19 for locoregional relapse) in pT4 colon cancer, valuable data for our peritoneal malignancy toolbox.
Important nuance for patient care: no DFS/OS benefit yet, so multidisciplinary selection and informed consent remain non-negotiable.
We celebrate every rigorous trial while keeping ethics, equity, and long-term outcomes front and center.
Thank you for the evidence-based post!
Source: Martinez Lago et al. (2025). HIPECT4 trial. BJS Open. academic.oup.com/bjsopen/art…
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Efficacy and safety of intraoperative hyperthermic intraperitoneal chemotherapy for locally advanced colorectal cancer (HIPECT4): final analysis of randomized clinical trial @BjsOpen academic.oup.com/bjsopen/art…
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Efficacy and safety of intraoperative hyperthermic intraperitoneal chemotherapy for locally advanced colorectal cancer (HIPECT4): final analysis of randomized clinical trial academic.oup.com/bjsopen/art…
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🔥 HIPECT4: HIPEC in locally advanced colon cancer (pT4)
📊 Phase III RCT (n=184)
♨️ HIPEC (mitomycin C)
📉 ↓ locoregional/peritoneal relapse
• HR 0.19 (p=0.031)
⚠️ No benefit in DFS or OS
💡 Improves peritoneal control, not survival
🔗 doi.org/10.1093/bjsopen/zrag…
@OncoAlert
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Mar 27
Efficacy and safety of intraoperative hyperthermic intraperitoneal chemotherapy for locally advanced colorectal cancer (HIPECT4): final analysis of randomized clinical trial @aecirujanos @PSOGI_EC @indepso @GrupoTTD @ISSPP1 academic.oup.com/bjsopen/art…
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Mar 7
Fantastic meeting @SocSurgOnc 2026 Phoenix, proud to be invited to talk about clinica la trial in peritoneal disease from colon cancer #hipect4 #foxhipect4 #gecopmmc. Sharing with friends dr Rupen Shah and @kturaga @HUReinaSofia @IMIBIC @AECP_FAECP @aecirujanos
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22 Oct 2025
The HIPECT4 trial (Arjona-Sánchez et al, 2023) using Combat PRS CO2 agitation showed that, at 3 years, patients who underwent cytoreduction plus #HIPEC with mitomycin C had a 10% absolute improvement in locoregional control – 97.6% vs 87.6% for cytoreduction alone.
#PSOGI2025
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Seems to be a pattern here. The systematic individual data meta analysis of HIpECT4 and COLoPEC demonstrate strongest efficacy also in right-sided tumors.
30 May 2025
Perioperative systemic therapy for resectable colorectal peritoneal metastases
#ASCO25
🔎 CAIRO-6 phs 3 trial
👉mPFS 14 vs 7 mo
👉mDFs 12 vs 7 mo
👉mOS 44 vs 39 mo
🧐 No OS benefit in IIT, but better OS in synchronous right-sided tumors
@myESMO
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18 May 2025
Adjuvant hyperthermic intraperitoneal chemotherapy in patients with colon cancer at high risk of peritoneal metastases: individual patient data meta-analysis
➡️ doi.org/10.1093/bjs/znaf076
Adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) did not significantly improve the locoregional recurrence rate, disease free-survival, and overall survival in patients with locally advanced colon cancer
A significant reduction in locoregional recurrence was found after adjuvant HIPEC in patients with right-sided tumours, especially those with proven pT4 stage tumours
There was a measurable impact of adjuvant HIPEC on intraperitoneal disease recurrence, but this required a specific study population with sufficient a priori risk.
Work by Julie J M Hamm , Rudolf van den Berg , Eleni-Rosalina Andrinopoulou , E Sophie Zwanenburg , Gijsbert D Musters , Pieter J Tanis , Alvaro Arjona-Sanchez , the COLOPEC and HIPECT4 Collaborator Groups
#SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #colorectalsurgery #StepUp4CRC @FightCRC @ACPGBI #ERAS @dice_europe #Crohn #proctology @Dukes_Club @ACPGBI_EduTrain @AECP_FAECP @PelvExGroup @escp_tweets @YouESCP #TeachMeColoproctology
#Some4COLoprocto
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A collaborative study between COLOPEC and HIPECT4 trials. @ISSPP1 @ESSOnews @ContraCancerEs @_SEOM @escp_tweets @coloproctoaec @IMIBIC
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@Richard_Hoehn published a interesting commentary in Cancer journal about HIPECT4 trial, he purposed a new challenge combining HIPEC and neoadjuvant therapy for T4 colon cancer, this project is ongoing called FOXHIPECT4 trial, involving 24 centers clinicaltrials.gov/study/NCT…
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The HIPECT4 phase 3 RCT found that adding #HIPEC with mitomycin C to cytoreductive surgery for locally advanced colorectal cancer significantly reduced the risk of locoregional recurrence.
👉bit.ly/3YzGBtM
#bowelcancerawareness #CombatCancer
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Great session about colorectal peritoneal mets, thanks to @ChiaClaramae to mention me, PIPAC review by @somusp9 and HIPECT4 explanation @dr_mohammadyami @PSOGI_EC @HUReinaSofia @aecirujanos
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30 Jan 2025
After read this article: some conclusions about it
@cascalescirugia @FarazKh65499316 @FaekJ @PSugarbaker @PSOGI_EC
1st.- T4 is associated to high rate of peritoneal recurrence, maybe HIPEC could avoid it as HIPECT4 trial showed jamanetwork.com/journals/jam…
28 Jan 2025
January Issue: Minimally Invasive Surgery: Is It a Risk Factor for Postoperative #PeritonealMetastasis in pT4 #ColonCancer ?
rdcu.be/d7HIj
@jeffreyfarma
@SyedAAhmad5
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