A study of cis-platinum and ifosfamide in alkylating agent-resistant ovarian cancer

Twenty patients with advanced epithelial ovarian carcinoma who had failed alkylating agent treatment were given cisplatin 60 mg/m2 together with ifosfamide 4 g/m2 and mesna 6 g/m2 every 4 weeks for 4-6 cycles. The overall response rate was 45% and the complete response rate 20%. The median time to disease progression was 9 months and 4 of the 9 responding patients are alive at more than 2 years. WHO Grade 3 or 4 myelosuppression was seen in 7 patients, nephrotoxicity in 4, and encephalopathy in 1 patient. Nausea and vomiting of moderate severity (WHO Grade 3) was seen in the majority of patients. While a dose escalation of 25% of both drugs was possible in 4 patients, myelosuppression became limiting at the higher dose. The combination of cisplatin and ifosfamide is effective in relapsed ovarian cancer even in this group of patients with heavy pretreatment.