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Gynecologic Oncology Group experience with ifosfamide.
G P Sutton1, J A Blessing, G Photopulos
1Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis 46202.
Seminars in Oncology
|April 1, 1990
Summary
Ifosfamide/mesna shows activity in advanced gynecologic cancers. This phase II trial found responses in ovarian, cervical, and uterine tumors, despite some toxicities.
Area of Science:
- Gynecologic Oncology
- Medical Oncology
- Pharmacology
Background:
- The Gynecologic Oncology Group initiated phase II trials to evaluate ifosfamide/mesna in advanced or recurrent gynecologic malignancies.
- Prior platinum-based therapy was common in ovarian and cervical cancer patients.
Purpose of the Study:
- To assess the efficacy and toxicity of ifosfamide/mesna in patients with advanced or recurrent gynecologic malignancies.
- To determine response rates and duration in epithelial ovarian, squamous cervical, and uterine mixed mesodermal tumors.
Main Methods:
- Phase II trial involving intravenous ifosfamide (1.5 g/m2/d for 5 days) and mesna.
- Dose reduction to 1.2 g/m2/d ifosfamide for patients with prior chemotherapy or radiotherapy.
- Evaluation of response rates, complete responses (CRs), and partial responses (PRs).
Main Results:
- Epithelial ovarian carcinoma: 20% response rate (7% CRs).
- Squamous carcinoma of the cervix: 11.1% partial response rate.
- Uterine mixed mesodermal tumors: 30.7% overall response rate (19.2% CRs).
- Significant toxicities included renal and neurologic impairment, though hematologic toxicity was manageable.
Conclusions:
- Ifosfamide/mesna demonstrates activity across a spectrum of gynecologic malignancies.
- The drug combination shows potential in treating advanced or recurrent disease, warranting further investigation.
- Careful dose adjustment and monitoring are necessary due to observed toxicities.