title: Ifosfamide in the treatment of germ cell tumors.
abstract: Ifosfamide is currently the third most active agent in the treatment of germ cell cancer, behind cisplatin and etoposide. Ifosfamide has single-agent activity comparable to etoposide in very poor-prognosis, cisplatin-refractory disease. In the salvage setting, ifosfamide-based combination chemotherapy can be expected to achieve disease-free status in approximately 50% of cisplatin-sensitive testicular cancer patients, although half of these patients will eventually relapse. As first-line therapy in previously untreated poor-risk patients, ifosfamide-based chemotherapy is therapeutically equivalent to standard therapy but associated with increased toxicity, especially myelosuppression. The role of high-dose ifosfamide in dose-intensive carboplatin/etoposide regimens for the treatment of recurrent disease is unknown and awaits clarification in future research. Current research with this drug continues primarily in the realm of refining ifosfamide-based salvage therapy.
authors.affiliation: Division of Hematology/Oncology, Indiana University School of Medicine, Indianapolis, 46202, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Nichols
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005047:Etoposide / Q000008:administration & dosage / Q000627:therapeutic use; D018237:Germinoma / Q000188:drug therapy*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D016879:Salvage Therapy; D013736:Testicular Neoplasms / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide