Ifosfamide given as a 24-h infusion with mesna in patients with recurrent ovarian cancer: preliminary results.
The continuous 24-h infusion of ifosfamide (IFX) with mesna was studied in 44 patients with therapy-resistant or relapsing ovarian cancer. All patients had stage III disease and had been pretreated with at least one combination comprising an alkylating agent and a cisplatin analogue (22, with one combination; 16, with two; and 6, with three or more). The median number of IFX cycles received was two. Of 40 evaluable patients, 2 achieved a complete response, 5 showed a partial response and 6 had stable disease. A total of 27 patients had tumor progression after one or two treatment cycles. All seven responders had responded to previous treatment for a median duration of 5 months (range, 5-41 months). No patients who progressed during alkylating-agent treatment responded to IFX given subsequently. The median progression-free period was 6 months (range, 4-12 months), and the median overall survival was only 6 months, indicating the advanced stage of disease in these patients. The median overall survival in progressive patients was 5 months (range 2-13+ months) and that in the remaining group was 13 months (ranges 3(+)-24 months) (P less than 0.05). This treatment was moderately well tolerated. Grade 3 nausea and vomiting occurred in 27% of cycles and grade 3-4 leukopenia was observed in 47%, but thrombocytopenia was hardly ever found. In eight patients there was a deterioration of renal function. Among a total of 131 cycles, the dose was reduced for only 9 due to myelotoxicity and for 3 due to nephrotoxicity. IFX seems to be active only in patients who have relapsed after responding to previous cytotoxic treatment.
Willemse
P H
PH
Department of Internal Medicine, University Hospital, Groningen, The Netherlands.
vd Burg
M E
ME
vd Gaast
A
A
Neijt
J P
JP
ten Bokkel Huinink
W W
WW
Aalders
J G
JG
de Vries
E G
EG
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage* / Q000009:adverse effects; D007262:Infusions, Intravenous; D008623:Mercaptoethanol / Q000031:analogs & derivatives*; D015080:Mesna / Q000008:administration & dosage*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D010051:Ovarian Neoplasms / Q000188:drug therapy*
D008623:Mercaptoethanol; D015080:Mesna; D007069:Ifosfamide