title: Ifosfamide/carboplatin/etoposide (ICE) for recurrent malignant solid tumors of childhood: a Pediatric Oncology Group Phase I/II study.
abstract: OBJECTIVE
  The combination of ifosfamide (I) and etoposide (E) was useful in salvaging patients with recurrent/resistant malignant solid tumors of childhood. Carboplatin (C), active against a number of pediatric cancers, was added to I and E to form a three-drug combination called ICE to improve the response rate.
  
  
  METHODS
  ICE, consisting of I 1.5 g/m2 plus E 100 mg/m2 i.v.q.d. x 3 plus C i.v. on day 3 only, was given in 21-28-day intervals. C was started at 300 mg/m2, and the dose was escalated in 25% increments, with three evaluable patients treated at each level.
  
  
  RESULTS
  Ninety-two patients were enrolled in this phase I/II study between July 1990 and April 1993. A total of 331 courses of ICE was administered. Median courses of ICE received were three (range, 1-16). The maximum tolerated dose (MTD) for C when used in combination was found to be 635 mg/m2. The response rate for ICE at the MTD for C was complete response (CR) 26% and CR + partial response (PR) 53%. The response was even better in those who received C at the MTD: 32% achieving a CR and 63% a CR + PR. Pancytopenia was the dose-limiting toxicity. Thirteen episodes of bacterial infection were reported, none fatal. Only one patient developed a Fanconi-like syndrome.
  
  
  CONCLUSIONS
  The MTD of C when used with I and E was found to be 635 mg/m2. The overall CR + PR rate for all patients treated at all C dose levels was 53%. Best responses were seen in non-Hodgkin's lymphoma, neuroblastoma, soft tissue sarcomas, and Wilms' tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: UCSD School of Medicine, La Jolla, USA.
authors.forename: F H
authors.initials: FH
authors.lastname: Kung
authors.forename: S J
authors.initials: SJ
authors.lastname: Desai
authors.forename: J D
authors.initials: JD
authors.lastname: Dickerman
authors.forename: A M
authors.initials: AM
authors.lastname: Goorin
authors.forename: M B
authors.initials: MB
authors.lastname: Harris
authors.forename: S
authors.initials: S
authors.lastname: Inoue
authors.forename: J P
authors.initials: JP
authors.lastname: Krischer
authors.forename: S B
authors.initials: SB
authors.lastname: Murphy
authors.forename: C B
authors.initials: CB
authors.lastname: Pratt
authors.forename: S
authors.initials: S
authors.lastname: Toledano
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D012008:Recurrence
chemical_list: D005047:Etoposide; D016190:Carboplatin; D007069:Ifosfamide