Ifosfamide/Mesna as Salvage Therapy in Platinum Pretreated Ovarian Cancer Patients-Long-Term Results of a Phase II Study

• Published in: Cancer investigation Vol. 24; no. 1; pp. 22 - 27
• Main Authors: Baur, Martina, Fazeny-Doerner, B., Hudec, M., Sevelda, P., Salzer, H., Dittrich, Christian
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01-01-2006; Taylor & Francis
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - mortality; Advanced ovarian cancer; Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Female; Humans; Ifosfamide; Ifosfamide - administration & dosage; Mesna; Mesna - administration & dosage; Middle Aged; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - mortality; Platinum Compounds - therapeutic use; Platinum pretreatment; Protective Agents - administration & dosage; Salvage Therapy; Survival Analysis; Treatment Outcome
• ISSN: 0735-7907; 1532-4192
• DOI: 10.1080/07357900500449595

Purpose: Salvage chemotherapy in advanced ovarian cancer is not yet standardized. Patients: Twenty-one consecutive patients progressing on or relapsing after previous platinum-containing treatment were eligible for treatment with ifosfamide 5 g/m2 infused over a 24-hour period every 3 weeks in a Phase II trial. After an initial bolus of 1 g/m2 of mesna, mesna was applied at a dosage of 5 g/m2 concomitantly with ifosfamide followed by additional dosages of 200 mg 3 times at 4-hour intervals after termination of the ifosfamide infusion. Results: The rate of objective responses was 19 percent, with a 95%CI [5.45-41.91 percent]. One patient achieved a pathologic complete remission (pCR) and 3 patients a clinical partial remission (PR). Median time-to-progression was 3 months. One patient was a long-term survivor. Main toxicities according to NCI-CTC included Grade 4 neurotoxicity in one patient, Grade 3 gastrointestinal toxicity in 5 patients, Grade 3 infection in one patient, and Grade 3 and 4 leucopenia in 6 and 2 patients, respectively. Conclusions: Monotherapy with ifosfamide represents an active regimen for salvage chemotherapy in advanced ovarian cancer patients progressing on or relapsing after previous platinum-pretreatment, even yielding a long-term surivor.