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High-dose ifosfamide by infusion with Mesna in advanced refractory sarcomas
I Güllü1, S Yalçin, G Tekuzman
1Hacettepe University, Institute of Oncology, Ankara, Turkey.
Cancer Investigation
|January 1, 1996
Summary
Second-line ifosfamide (IF) and mercaptoethane sulfonate sodium (Mesna) showed limited efficacy in advanced sarcomas, with low response rates and significant toxicities like myelosuppression and encephalopathy.
Area of Science:
- Oncology
- Medical Oncology
- Pharmacology
Background:
- Advanced sarcomas often require second-line chemotherapy after initial treatments.
- Doxorubicin and cyclophosphamide are common first-line agents for sarcoma.
Purpose of the Study:
- To evaluate the efficacy and toxicity of ifosfamide (IF) combined with mercaptoethane sulfonate sodium (Mesna) as second-line chemotherapy for advanced sarcomas.
Main Methods:
- A pilot study involving twenty patients with advanced sarcomas previously treated with doxorubicin and cyclophosphamide.
- Ifosfamide (3 g/m2 continuous infusion over 24 hours, days 1-5) with Mesna was administered every 4 weeks for up to six cycles.
Main Results:
- Only 2 patients (11%) achieved partial response (PR), with no complete responses (CR).
- High-grade tumors showed a 22% response rate.
- Dose-limiting toxicities included myelosuppression (22%) and encephalopathy (17%).
- Sixteen patients required protocol changes due to stable or progressive disease.
Conclusions:
- Ifosfamide/Mesna at this dose and schedule demonstrated limited promise as a second-line treatment for refractory advanced sarcomas.
- The observed toxicities and low response rates suggest this regimen may not be optimal for this patient population.