Ifosfamide with mesna in squamous carcinoma of the cervix: Phase II results in patients with advanced or recurrent disease

Hannigan, Edward V.; Dinh, Tung Van; Doherty, M.G.

doi:10.1016/0090-8258(91)90057-c

Cited by 13 publications

(5 citation statements)

References 11 publications

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“…The fact that several patients had a symptomatic response, despite concurrent disease progression, may be due to the anti‐inflammatory effect of dexamethasone, given as an antiemetic. In a group of patients, 97% of whom failed after radiotherapy and 53% after platinum combination chemotherapy, this RR is consistent with other reported series ( 4 –7 ) .…”

Section: Discussionsupporting

confidence: 92%

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Palliative chemotherapy in recurrent carcinoma of the cervix: an audit of the use of ifosfamide and review of the literature

Lodge

Blake

1999

Int J Gynecol Cancer

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A review was conducted on 34 patients treated with intravenous ifosfamide for relapsed, inoperable carcinoma of the cervix between 1988 and 1996. The median age of patients was 44 years. Thirty-two patients had squamous cell carcinoma and 2 had adenocarcinoma. Radiotherapy had been used in primary management in 33, neo-adjuvant platinum chemotherapy in 7, and previous palliative chemotherapy in 11. Symptomatic response was assessed with respect to the symptom requiring palliaton. 25 patients failed to complete 6 cycles of chemotherapy: due to progressive disease in 14, lack of symptom response in 2, and toxicity in 11 of whom 7 had encephalopathy sufficient to abandon treatment. 32 patients were evaluable for objective response. Pathologic complete response (CR) was achieved in 1 patient, and partial response (PR) was achieved in 3 patients. The objective response rate was 11.8%. Symptomatic response throughout treatment occurred in 8 patients (24%); objective response was seen in only 3 (1 CR, 2 PR) of them and progressive disease in the remaining 5. Response duration in the 4 objective responders was 25 months in the patient with CR and 4, 6 and 8 weeks in the 3 patients with PR. In conclusion, ifosfamide, as given, is associated with unacceptable toxicity and insufficient symptomatic efficacy for use as a palliative treatment in patients with relapsed carcinoma of the cervix.

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Section: Discussionsupporting

confidence: 92%

“…In the 5 phase II studies of single agent ifosfamide in cervical carcinoma that included patients who had received no previous chemotherapy, overall response rates of 16–50% were achieved ( 4 –8 ) . Two trials included patients who had received prior chemotherapy and only 3 partial responses (PR) were seen in 36 patients ( 4 , 5 ) .…”

mentioning

confidence: 99%

Palliative chemotherapy in recurrent carcinoma of the cervix: an audit of the use of ifosfamide and review of the literature

Lodge

Blake

1999

Int J Gynecol Cancer

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“…In an early study, 33% of patients responded to a 24 h infusion of 5 gm -2 every 21 days (2). Fractionated ifosfamide has also been used; three weekly cycles of 1.5 gm -2 daily for 5 days produced a response of 40% (3), although in a later report where one-quarter of patients had received prior chemotherapy, this was 20.8% (4) . An overall response of 50% has been described using a higher dose of 3.5 gm -2 daily for 5 days (5).…”

Section: Abstract: Bleomycin Cervix Neoplasms Ifosfamidementioning

confidence: 99%

“…Six (21%) partial responses were seen (95%CI: 6-36%) and the median duration of response was 5 months (range 3-8). The median interval to progression in the non-responding patients was 6 weeks (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Forty sites of disease were assessable for response.…”

Section: Responsementioning

confidence: 99%

A phase II study of ifosfamide and bleomycin in advanced or recurrent cervical carcinoma

Highley¹,

Samandas²,

Ziras³

et al. 1996

Int J Gynecol Cancer

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Harper PG. A phase II study of ifosfamide and bleomycin in advanced or recurrent cervical carcinoma. Int J Gynecol Cancer 1996; 6: 323-327.Thirty-seven patients with advanced or recurrent cervical squamous cell carcinoma were treated with ifosfamide 1.5 gm -2 on days 1-5 (with mesna as a uroprotector), and bleomycin 30 mg on day 1, every 3 weeks. A partial response rate of 21% (95%CI: 6-36%) was obtained in patients who had not received prior chemotherapy, with a median duration of response of 5 months. No complete responses were seen. The median survival of all patients was 6 months. Nausea and vomiting, white cell suppression and encephalopathy were the main toxic effects. The results suggest that the addition of bleomycin to ifosfamide is not advantageous and increases toxicity, and that the interaction between these two agents is not contributory to the activity of the bleomycin, ifosfamide and cisplatin combination regimen (BIP). The potentially more severe toxicity of combination regimens must be considered when treating this group of patients.

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“…Several compounds have been tested in squamous cell carcinoma. Cisplatin and ifosfamide are considered among the most active drugs in both neoadjuvant and salvage treatments [19, 31, 32, 33]. …”

Section: Neoadjuvant Treatmentmentioning

confidence: 99%

Role of Ifosfamide in Cervical Cancer: An Overview

Buda¹,

Dell’Anna²,

Signorelli³

et al. 2003

Oncology

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Ifosfamide, a cyclophosphamide analogue, has demonstrated a wide spectrum of activity against numerous neoplasms in different oncologic areas, including paediatric, haematological, breast, lung and testicular cancers, soft tissue sarcomas and gynaecological cancer. In gynaecologic cancers in particular, evidence suggests activity in the treatment of epithelial ovarian cancer, cervical carcinoma, germ cell carcinoma of the ovary. Cervical cancer has long been considered a poorly chemosensitive tumour and for several years the role of chemotherapy in the treatment of this tumour was confined to persistent or recurrent disease after failure of surgery and/or radiotherapy. In the management of cervical cancer, chemotherapy has received increasing attention in the last two decades and is currently used in neoadjuvant regimens, as salvage treatment in patients with disseminated or recurrent disease, or as a radiosensitizer. Over the past 30 years, several agents have been tested but cisplatin and ifosfamide are the agents that have attracted the greater attention. Cisplatin represents the cornerstone of chemotherapy for cervical cancer. Ifosfamide has been studied as a single agent or in combination with other drugs in different studies. In this paper we reviewed the approach with systemic therapy and, in particular, the role of ifosfamide in advanced or recurrent, and less advanced cervical cancer.

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Ifosfamide with mesna in squamous carcinoma of the cervix: Phase II results in patients with advanced or recurrent disease

Cited by 13 publications

References 11 publications

Palliative chemotherapy in recurrent carcinoma of the cervix: an audit of the use of ifosfamide and review of the literature

Palliative chemotherapy in recurrent carcinoma of the cervix: an audit of the use of ifosfamide and review of the literature

A phase II study of ifosfamide and bleomycin in advanced or recurrent cervical carcinoma

Role of Ifosfamide in Cervical Cancer: An Overview

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