Ifosfamide given as a 24-h infusion with mesna in patients with recurrent ovarian cancer : preliminary results

• Published in: Cancer chemotherapy and pharmacology 1990, Vol.26 (S1), p.S51-S54
• Main Authors: WILLEMSE, P. H. B, BURG, M. E. L. V. D, GAAST, A. V. D, NEIJT, J. P, BOKKEL HUININK, W. W, AALDERS, J. G, DE VRIES, E. G. E
• Format: Article
• Language: English
• Subjects: Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Chemotherapy; Female; Humans; Ifosfamide - administration & dosage; Ifosfamide - adverse effects; Infusions, Intravenous; Medical sciences; Mercaptoethanol - analogs & derivatives; Mesna - administration & dosage; Neoplasm Recurrence, Local - drug therapy; Ovarian Neoplasms - drug therapy; Pharmacology. Drug treatments
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/BF00685420

The continuous 24-h infusion of ifosfamide (IFX) with mesna was studied in 44 patients with therapy-resistant or relapsing ovarian cancer. All patients had stage III disease and had been pretreated with at least one combination comprising an alkylating agent and a cisplatin analogue (22, with one combination; 16, with two; and 6, with three or more). The median number of IFX cycles received was two. Of 40 evaluable patients, 2 achieved a complete response, 5 showed a partial response and 6 had stable disease. A total of 27 patients had tumor progression after one or two treatment cycles. All seven responders had responded to previous treatment for a median duration of 5 months (range, 5-41 months). No patients who progressed during alkylating-agent treatment responded to IFX given subsequently. The median progression-free period was 6 months (range, 4-12 months), and the median overall survival was only 6 months, indicating the advanced stage of disease in these patients. The median overall survival in progressive patients was 5 months (range 2-13+ months) and that in the remaining group was 13 months (ranges 3(+)-24 months) (P less than 0.05). This treatment was moderately well tolerated. Grade 3 nausea and vomiting occurred in 27% of cycles and grade 3-4 leukopenia was observed in 47%, but thrombocytopenia was hardly ever found. In eight patients there was a deterioration of renal function. Among a total of 131 cycles, the dose was reduced for only 9 due to myelotoxicity and for 3 due to nephrotoxicity. IFX seems to be active only in patients who have relapsed after responding to previous cytotoxic treatment.