title: Efficacy and tolerability of the ifosfamide-epirubicin combination in relapsed ovarian cancer.
abstract: A retrospective study evaluating the efficacy and tolerability of epirubicin-ifosfamide (EI) in patients with relapsed advanced ovarian cancer (ROC) after prior chemotherapy was conducted. A total of 93 patients received epirubicin (50 mg/m(2), day 1), ifosfamide (1500 or 2500 mg/m(2), days 1-3), and mesna monthly. Thirty-five percent had received one line of chemotherapy (platinum 100%, taxanes 8%); 38%, two lines; and 27%, more than two lines. Fifty-three percent received 2500 mg/m(2)/day ifosfamide and 47% received 1500 mg/m(2)/day ifosfamide. Ifosfamide was administered by continuous infusion in 12 patients. Mean number of courses was 4 (1-12). Grade 4 toxicity was 69% neutropenia and 12% thrombocytopenia. Three patients on high-dose ifosfamide as a short infusion had central nervous system dysfunction resulting in death. There were 84 assessable patients: 7 (8%), complete responses; 13 (15%), partial responses; and 20 (24%), stable disease. Median time to progression was 5 months (3 days to 36 months). The EI combination appears to be effective in ROC. However, toxicity with high-dose ifosfamide administered by short infusion is not acceptable. Tolerability can be improved using ifosfamide at 1500 mg/m(2) by continuous infusion. The combination of ifosfamide with newer anthracycline agents such as liposomal doxorubicin may be an alternative and needs further evaluation for use after first-line taxane-based chemotherapy.
authors.affiliation: Medical Oncology Department, Centre de Lutte contre le Cancer Francois Baclesse, Route de Lion sur Mer, BP 5026, 14076 Caen Cedex 05, France. f.joly@baclesse.fr
authors.forename: F
authors.initials: F
authors.lastname: Joly
authors.forename: H
authors.initials: H
authors.lastname: Bourgeois
authors.forename: A
authors.initials: A
authors.lastname: Floquet
authors.forename: P
authors.initials: P
authors.lastname: Chinet-Charrot
authors.forename: F
authors.initials: F
authors.lastname: Meyer
authors.forename: D
authors.initials: D
authors.lastname: Lebrun
authors.forename: K
authors.initials: K
authors.lastname: Hamond
authors.forename: C
authors.initials: C
authors.lastname: Leroy
authors.forename: J F
authors.initials: JF
authors.lastname: Heron
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016879:Salvage Therapy; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D015251:Epirubicin; D007069:Ifosfamide