PHASE-II TRIAL OF IFOSFAMIDE WITH MESNA IN PREVIOUSLY TREATED METASTATIC SARCOMA

  • 1 January 1985
    • journal article
    • research article
    • Vol. 69  (5) , 499-504
Abstract
Ifosfamide, given to 42 patients i.v. at 2-2.5 g/m2/day .times. 4, resulted in partial responses in 10 of 28 (36%) evaluable patients with adult soft tissue sarcomas, including 2 of 2 with chondrosarcoma; none of 9 with pediatric sarcomas (Ewing''s sarcoma, osteogenic sarcoma, or rhabdomyosarcoma) achieved partial response. All of the pediatric patients had failed to respond to complicated 3-6-drug regimens of up to 18 mo. in duration. The response rates in patients with and without prior cyclophosphamide (32%; 7 responses among 22 patients; and 20%, 3 responses among 15 patients) were not significantly different, supporting in vitro evidence of a lack of cross-resistance between the 2 related compounds. Myelosuppression was dose-limiting. Hemorrhagic cystitis was not observed in patients treated with 400-500 mg of mesna i.v. every 4 h during ifosfamide treatment. Nausea and vomiting were generally mild or moderate. Alopecia was universal but reversible. Of the 1st 11 patients, 5 became somnolent or developed visual hallucinations (during 6 of the 12 total courses administered to the 5 patients). Only 1 patient had 2 episodes of neurotoxicity. After reduction of the use of i.v. antiemetics and major narcotics, single episodes of neurotoxicity were seen in 5 of the next 27 patients. As asymptomatic acidosis developed in most patients requiring bicarbonate replacement in 1. Ifosfamide appears to be active in previously treated patients with sarcomas and should be evaluated in patients with less extensive prior treatment.