Could Tumor Biology Help Personalize HIPEC Treatment for Colorectal Cancer?
- 1 day ago
- 2 min read
Gupta P, Godfrey EL, Schultz KS, Qiao L, Aguirre N, Bader JM, Foote MB, Shen JP, Shergill AP, Cecchini M, Sundar R, Sheltzer JM, Turaga KK. Consensus Molecular Subtypes Inform HIPEC Agent Selection in Colorectal Cancer Peritoneal Metastases. Ann Surg Oncol. 2026 Jul;33(7):6140-6145. doi: 10.1245/s10434-025-19057-z. Epub 2026 Feb 3. PMID: 41634518.
What was this study about?
Researchers wanted to better understand why some patients with colorectal cancer that has spread to the lining of the abdomen (peritoneal metastases) respond well to HIPEC, while others do not.
HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is a treatment in which heated chemotherapy is delivered directly into the abdomen during surgery. While HIPEC can help some patients, not everyone benefits equally.
The researchers investigated whether different molecular subtypes of colorectal cancer respond differently to the chemotherapy drugs commonly used during HIPEC.
What did the researchers do?
The research team analyzed 34 colorectal cancer cell lines and grouped them into four recognized molecular subtypes, known as CMS1, CMS2, CMS3, and CMS4.
They then examined how these different subtypes responded to five chemotherapy drugs that may be used during HIPEC:
Mitomycin C
Oxaliplatin
Irinotecan
5-fluorouracil (5-FU)
Cisplatin
The goal was to determine whether certain tumor subtypes might be more sensitive to specific drugs.
What did the researchers find?
The study found that tumors belonging to the CMS4 subtype appeared to be more sensitive to:
Mitomycin C
Irinotecan
However, CMS4 tumors did not show increased sensitivity to:
Oxaliplatin
5-FU
Cisplatin
Researchers also found that CMS3 tumors showed sensitivity to irinotecan, while CMS1 and CMS2 tumors appeared less responsive to some of these treatments.
Why is this important for patients?
These findings suggest that a "one-size-fits-all" approach to HIPEC may not be ideal.
In the future, doctors may be able to use information about a tumor's molecular subtype to help choose the chemotherapy drug most likely to be effective for an individual patient.
This type of personalized treatment approach could potentially:
Improve outcomes
Reduce exposure to less effective therapies
Help identify which patients are most likely to benefit from HIPEC
What does this mean for current treatment?
The study may help explain why previous HIPEC research has produced mixed results.
For example, some clinical studies have shown benefits when mitomycin C was used during HIPEC, while studies using oxaliplatin have been less successful. The researchers suggest that differences in tumor biology could be one reason for these varying outcomes.
What are the limitations?
This was a laboratory study using cancer cell lines rather than patients.
That means the results do not prove that patients with CMS4 tumors will have better outcomes with mitomycin C or irinotecan during HIPEC. Additional clinical trials involving patients are needed before treatment recommendations can change.
Bottom Line
This study suggests that the biology of a colorectal cancer tumor may influence how well it responds to different HIPEC chemotherapy drugs. Researchers found that the CMS4 subtype appeared particularly sensitive to mitomycin C and irinotecan, raising the possibility that future HIPEC treatments could be tailored to a patient's specific tumor characteristics. More clinical research is needed before these findings can be applied in routine patient care.
