Prolonged 14‐day continuous infusion of high‐dose ifosfamide with an external portable pump: Feasibility and efficacy in refractory pediatric sarcoma

Abstract

BackgroundIfosfamide is currently used to treat pediatric sarcomas and increasing its dosage may be associated with a better response rate. Prolonged continuous infusion seems an attractive administration modality.MethodsIfosfamide 14 g/m2 (with mesna 14 g/m2) was administered through an ambulatory portable pump over 14 days as a continuous infusion, starting every 3 weeks, in 14 patients with relapsing sarcomas. No growth factors were given.ResultsAcute grade 3 hematological toxicity was observed in only 13/66 cycles and red cell transfusions were given in two patients. Hematuria and dysuria occurred in three cases. The response rate was: five partial responses, five stable disease. The median time to progression was 3 months (range: 2–19 months). The best response rate was seen for synovial sarcoma and Ewing sarcoma.ConclusionProlonged 14‐day continuous infusion of high‐dose ifosfamide is well tolerated. Potentially interesting preliminary responses in pediatric patients already treated with ifosfamide are reported. Pediatr Blood Cancer. 2010;55:617–620. © 2010 Wiley‐Liss, Inc.

Clinical Activity and Tolerability of a 14-Day Infusional Ifosfamide Schedule in Soft-Tissue Sarcoma

“…Whatever the reason, delivery of cycle one at a lower dose (for instance, 750 mg/m 2 /day) and dose escalation should be taken into consideration if treatment is tolerated in female patients, given the increased risk of encephalopathy observed. Interestingly, this toxicity profile differs from the one previously reported by Meazza et al [12]. In their paediatric population, only 4 out of 14 patients experienced mild nausea, and antiemetic prophylaxis was required in only a minority of patients.…”

Synovial sarcoma relapses in children and adolescents: Prognostic factors, treatment, and outcome

“…SS may therefore remain sensitive, although slightly less so, to ifosfamide-based chemotherapy regimens. In the absence of excessively high previous cumulative doses or renal toxicity, this chemotherapy can also be used to treat SS relapses [24]. Patients with initially metastatic SS diseases have a very poor prognosis (5-year OS of about 13% [4]).…”

Malignant Pediatric Bone Tumors - Treatment & Management

“…A response rate of 35 % in heavily pretreated patients is a promising fi nding, even in patients who were already previously treated with ifosfamide (Meazza et al 2010 ). This study reported very low incidence of nausea, no encephalopathy or renal toxicity, low incidence of bladder toxicity, and reduction in cytopenias.…”