Gynecologic Oncology Group studies with ifosfamide

Area of Science:

• Gynecologic Oncology
• Medical Oncology
• Pharmacology

Background:

• The Gynecologic Oncology Group has a history of phase II trials evaluating ifosfamide and mesna since 1985.
• Ifosfamide, a chemotherapy agent, is often administered with mesna to mitigate toxicity.

Purpose of the Study:

• To assess the efficacy and response rates of ifosfamide and mesna in various gynecologic malignancies.
• To evaluate dose modifications of ifosfamide in patients with prior treatment history.

Main Methods:

• Phase II clinical trials were conducted by the Gynecologic Oncology Group.
• Ifosfamide was administered intravenously at 1.5 g/m2/d for 5 days, with mesna as a uroprotectant.
• Dose reduction to 1.2 g/m2/d was implemented for patients with prior chemotherapy or radiotherapy due to observed toxicities.

Main Results:

• Epithelial ovarian cancer: 20% response rate (7% complete response).
• Squamous cervical carcinoma: 11.1% response rate in platinum-pretreated patients; 15.7% in previously untreated patients.
• Nonsquamous cervical carcinoma: 12% response rate.
• Endometrial adenocarcinomas: 8.6% response rate in previously treated patients.
• Uterine sarcomas: response rates ranged from 17.2% to 30.7% across subtypes.
• Ovarian sarcomas: 27.8% response rate.

Conclusions:

• Ifosfamide and mesna demonstrated activity across a spectrum of gynecologic cancers, with notable variability in response rates.
• Dose adjustments may be necessary for patients with prior treatment exposure to manage toxicity.
• Further studies exploring ifosfamide combinations are ongoing.