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Ifosfamide in germ cell tumors.
1Division of Hematology/Oncology and Walther Cancer Institute, Indianapolis, IN 46202, USA. leinhorn@iupui.edu
Oncology
|October 31, 2003
Summary
Ifosfamide-based chemotherapy, including etoposide (VP-16) + ifosfamide + cisplatin (VIP), shows promise for germ cell tumors. VIP is a viable first-line option for patients at risk of bleomycin toxicity.
Area of Science:
- Oncology
- Medical Chemotherapy
Background:
- Ifosfamide demonstrates significant single-agent activity in germ cell tumors.
- Combination chemotherapy regimens involving ifosfamide have been explored since 1982.
Purpose of the Study:
- To evaluate the efficacy of ifosfamide-based chemotherapy regimens in germ cell tumor patients.
- To compare etoposide (VP-16) + ifosfamide + cisplatin (VIP) with bleomycin + etoposide + cisplatin (BEP) as initial chemotherapy.
Main Methods:
- Retrospective analysis of salvage chemotherapy data.
- Phase III studies comparing VIP and BEP regimens.
- Assessment of cure rates and toxicity profiles.
Main Results:
- The etoposide (VP-16) + ifosfamide + cisplatin (VIP) regimen achieved cures in a refractory setting.
- Ifosfamide-cisplatin combination chemotherapy demonstrated a 25% cure rate as second-line therapy.
- Phase III studies showed comparable efficacy between VIP and BEP, with BEP being less toxic.
Conclusions:
- The etoposide (VP-16) + ifosfamide + cisplatin (VIP) regimen is an effective salvage and second-line treatment for germ cell tumors.
- VIP is a suitable alternative first-line regimen for patients with concerns regarding bleomycin-induced pulmonary fibrosis.