14-day continuous infusion ifosfamide in advanced refractory sarcomas.

Continuous 14 Day Infusional Ifosfamide for Management of Soft-Tissue and Bone Sarcoma: A Single Centre Retrospective Cohort Analysis

“…Toxicity within this cohort is consistent with previous studies on the use of infusional ifosfamide. A G2–4 neutropenia rate of 33% is similar to previous studies reporting rates of 43% G3–4 neutropenia (30 patients) and 53% all-grade neutropenia (51 patients) [ 15 , 16 ] These differences do not describe the use of GCSF, the use of which has increased in recent years. A febrile neutropenia rate of 15%, was significantly lower than with high-dose fractionated ifosfamide given in paediatric populations [ 24 , 25 ].…”

“…Presented results are interpreted cautiously, recognising that treatment was given outside of the clinical trial setting, and therefore RECIST reporting was not available and adverse-event data were retrospectively collated. Previously reported mPFS for mixed BS and STS cohorts treated with infusional ifosfamide have been 2.9 m in a mixed cohort of 30 patients [ 15 ] and 3 m in a mixed cohort of 51 patients [ 16 ], consistent with the mPFS of 3.4 m in this cohort. Median OS in a patient group treated with ifosfamide at 2 g/m 2 /6 days every 3 weeks was reported as 8.7 m (30 patients) [ 15 ], compared to 11.8 m in the present cohort.…”

“…Literature on the use of infusional ifosfamide in BS populations is more limited than that of STS, with the majority of reported studies performed on heterogeneous groups containing both BS and STS patients [ 15 , 16 ], or extrapolated from studies of conventional high-dose ifosfamide in paediatric populations [ 22 ]. Grouped outcomes in our BS cohort are comparable to published studies with reported mPFS values of 2.9 m and 3 m [ 15 , 16 ], compared to 2.5 m in our cohort.…”

“…The most commonly reported non-haematological toxicities were nausea and vomiting and fatigue, findings consistent with previously reported cohorts [ 13 ]. Moreover, a rate of 8% for suspected or confirmed encephalopathy is comparable to previous reports of incidences of 4%, 7%, 11% and 17% and no sustained renal toxicity was observed [ 13 , 14 , 15 , 16 ]. Toxicity rates were similar between STS and BS cohorts, and between younger TYA and adult patients.…”

“…In our cohort we reported one on-treatment death from ARDS following a prolonged ITU admission with neutropenic sepsis. On-treatment deaths with infusional ifosfamide are rare, but important, with two other cohorts experiencing one on-treatment death each [ 15 , 16 ], consistent with the experience presented here.…”