Single-agent ifosfamide studies in sarcomas of soft tissue and bone: the M.D. Anderson experience.
We have used ifosfamide to treat patients with sarcomas in four completed single-agent protocols and one pilot study since 1985. All the studies have used either N-acetyl-L-cysteine (NAC) or mesna as a uroprotective agent, except in one arm of one study where hydration alone was employed. Mesna has proven superior to NAC in providing protection against ifosfamide-induced hematuria. Mesna given as a loading dose followed by continuous 24-h infusion has been effective and most practical in this regard. Ifosfamide has demonstrated clinically useful antitumor activity in our hands against most sarcoma subtypes. Our studies suggest a dose-response relationship for ifosfamide. At a total dose of 6 g/m2 per course, the overall response rate was 10%; at 10 g/m2 per course, it rose to 21%. Future clinical trials will determine ifosfamide's role in combination chemotherapy and more clearly define the best schedule or schedules for the uroprotective administration of mesna.
Benjamin
R S
RS
Department of Melanoma-Sarcoma Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Legha
S S
SS
Patel
S R
SR
Nicaise
C
C
D000111:Acetylcysteine / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy*; D005440:Fluid Therapy; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects / Q000627:therapeutic use*; D015080:Mesna / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012509:Sarcoma / Q000188:drug therapy*; D012983:Soft Tissue Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000139:chemically induced / Q000517:prevention & control*
D015080:Mesna; D007069:Ifosfamide; D000111:Acetylcysteine