Related Experiment Videos
Controlled clinical studies with an antidote against the urotoxicity of oxazaphosphorines: preliminary results
Abstract:
A randomized study in 20 patients with cancer was carried out to test the clinical efficacy of sodium-2-mercaptoethane sulfonate (ASTA D-7093; mesnum) as an agent to prevent urotoxic side effects (in particular, hemorrhagic cystitis) during cytostatic therapy with the oxazaphosphorines cyclophosphamide and ifosfamide. Eleven patients received mesnum iv and nine patients received a standard prophylaxis. The frequency of microhematuria was significantly lower in the patients receiving mesnum. A slight microhematuria was observed in one patient. With the standard prophylaxis, all nine patients receiving single-agent therapy with ifosfamide or cyclophosphamide had hematuria and three of these had macrohematuria. According to the available results, a daily mesnum dose of 60% (wt/wt) of the ifosfamide or cyclophosphamide dose is recommended. This dose should be divided into three equal fractions. The first administration should be given concurrently with the cytostatic agent and the subsequent two administrations at 4 and 8 hours after administration of the cytostatic agent. Significantly higher doses of mesnum (eg, 133% of the cyclophosphamide or ifosfamide doses) lead to gastrointestinal disorders, which are easily reversible.
Insights
Sodium-2-mercaptoethane sulfonate (mesnum) significantly reduced hematuria in cancer patients undergoing chemotherapy. Mesnum is recommended at 60% of the cytostatic dose, divided into three administrations, to prevent urotoxic side effects.
Area of Science:
- Oncology
- Pharmacology
- Urology
Background:
- Cytostatic chemotherapy with cyclophosphamide and ifosfamide can cause urotoxic side effects, particularly hemorrhagic cystitis.
- Preventing these side effects is crucial for patient tolerance and treatment adherence.
Purpose of the Study:
- To evaluate the clinical efficacy of sodium-2-mercaptoethane sulfonate (mesnum) in preventing urotoxic side effects during cyclophosphamide and ifosfamide therapy.
- To determine the optimal dosage and administration schedule for mesnum.
Main Methods:
- A randomized study involving 20 cancer patients.
- Comparison of mesnum intravenous administration versus standard prophylaxis.
- Monitoring for microhematuria and macrohematuria.
Main Results:
- Significantly lower frequency of microhematuria in the mesnum group compared to standard prophylaxis.
- All patients on standard prophylaxis experienced hematuria, with three cases of macrohematuria.
- Higher mesnum doses (133% of cytostatic dose) led to reversible gastrointestinal disorders.
Conclusions:
- Mesnum is effective in preventing hemorrhagic cystitis and other urotoxic side effects associated with cyclophosphamide and ifosfamide.
- A recommended daily mesnum dose is 60% (wt/wt) of the cytostatic dose, divided into three administrations.
- Optimal administration involves concurrent administration with the cytostatic agent, followed by doses at 4 and 8 hours.