Complete remission of refractory gestational trophoblastic disease with brain metastases treated with multicycle ifosfamide, carboplatin, and etoposide (ICE) and stem cell rescue.
Patients with chemotherapy-refractory gestational trophoblastic disease and brain metastasis are considered to have a very poor prognosis. We present the case of a patient who had failed several chemotherapeutic regimens. Despite transient responses to chemotherapy, she had not achieved a complete remission in 3 years, and had developed systemic disease and recurrent brain metastasis. She was treated with four cycles of high-dose ifosfamide, carboplatin, and etoposide with blood progenitor cell support. She tolerated this regimen well and has obtained a complete remission that is ongoing for 12 months.
van Besien
K
K
Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Verschraegen
C
C
Mehra
R
R
Giralt
S
S
Kudelka
A P
AP
Edwards
C L
CL
Piamsonboom
S
S
Termrungruanglert
W
W
Champlin
R
R
Kavanagh
J J
JJ
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D011247:Pregnancy; D012074:Remission Induction; D014328:Trophoblastic Neoplasms / Q000556:secondary* / Q000628:therapy*; D014594:Uterine Neoplasms / Q000473:pathology / Q000628:therapy*
D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide