Ifosfamide and Etoposide Salvage Treatment in Advanced Ovarian Cancer

Bruzzone, M; Campora, E; Merlini, Laura; Giudici, Simone; Bottero, G; Iskra, L; Donadio, Michela; Ferrari, Ivan; Ragni, Nicola

doi:10.1080/1120009x.1991.11739115

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…Three of these phase II trials used IV etoposide (19-21), while the other two used oral etoposide (22, 23). Bruzzone et al (20) study resulted in no responses in 12 patients progressing or relapsing after primary cisplatin-containing combination, Trope et al (21) obtained the following results; in 29 patients who received cisplatin as first-line and were deemed to be platinum-resistant, used ETI regimen same dose to ours, RR was 21%, the median time to disease progression was 6 months. They presumed the response to ETI was independent of prior response to first-line cisplatin-based chemotherapy, since there is no cross-resistance between ETI regimen and cisplatin.…”

Section: Discussionmentioning

confidence: 80%

Phase II Study of Combination Chemotherapy with Etoposide and Ifosfamide in Patients with Heavily Pretreated Recurrent or Persistent Epithelial Ovarian Cancer

et al. 2009

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The aim of this trial was to investigate the efficacy and toxicity of combination chemotherapy with etoposide and ifosfamide (ETI) in the management of heavily pretreated recurrent or persistent epithelial ovarian cancer (EOC). Patients with recurrent or persistent EOC who had measurable disease and at least two prior chemotherapy participating in this phase II trial were to receive etoposide at a dose of 100 mg/m2/day intravenously (IV) on days 1 to 3 in combination with ifosfamide 1 g/m2/day IV on days 1 to 5, every 21 days. Thirty-seven patients were treated; about 78% had previously received more than two separate regimens. The response rate (RR) was 18.9% and median duration of response was 7 months (range, 1-15). Treatment free interval prior to ETI (TFI) has significant correlation with RR rate (P=0.034). Patients (n=6) with TFI ≥6 months had 50% of RR, while patients (n=31) with TFI <6 months had 12.9%. Median survival was 9 months at a median follow-up of 9.2 months. Grade 3 or 4 toxicities included neutropenia in 20.1% of the 139 cycles of ETI, anemia in 7.2% and thrombocytopenia in 8.6%. The ETI produces relatively low toxicity and modest activity in heavily pretreated recurrent or persistent EOC. This is significant in patients with TFI ≥6 months.

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Section: Discussionmentioning

confidence: 80%

Phase II Study of Combination Chemotherapy with Etoposide and Ifosfamide in Patients with Heavily Pretreated Recurrent or Persistent Epithelial Ovarian Cancer

et al. 2009

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“…In this condition, we can expect 34.5% RR and 9.2 months of median survival. Several reports including ours have been published on ETI regimen in recurrent EOC [13,[23][24][25][26]. It has been reviewed by Kang et al [14] Most of them used IV etoposide and ifosfmaide, but 2 investigators used oral etoposide and IV ifosfamide.…”

Section: Discussionmentioning

confidence: 98%

Retrospective Study of Combination Chemotherapy With Etoposide and Ifosfamide in Patients With Heavily Pretreated Recurrent or Persistent Epithelial Ovarian Cancer

Wonkyo¹

2017

Preprint

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Objective This retrospective study is to evaluate the efficacy and toxicity of combination chemotherapy with etoposide and ifosfamide (ETI) in the management of pretreated recurrent or persistent epithelial ovarian cancer (EOC). Methods Patients with recurrent or persistent EOC who had measurable disease and at least one chemotherapy regimen were to receive etoposide at a dose of 100 mg/m 2 /day intravenous (IV) on days 1 to 3 in combination with ifosfamide 1 g/m 2 /day IV on days 1 to 5, every 21 days. Results From August 2008 to August 2016, 66 patients were treated with ETI regimen. Most patients were heavily pretreated prior to ETI: 53 (80.3%) patients had received 3 or more chemotherapy regimens. The response rate (RR) of ETI chemotherapy was 18.2% and median duration of response was 6.8 months (range, 0-30). Median survival of all patients was 5 months at a median follow up of 7.2 months. Platinum-free interval (PFI) more than 6 months prior to ETI has statistically significant correlation with overall survival (OS; 9.2 vs. 5.6 months; P=0.029) and RR (34.5% vs. 5.4%; P<0.010). However, treatment free interval before ETI, number of prior chemotherapy regimen, and optimality of primary surgery did not show significant difference for RR or OS. Grade 3 or 4 hematologic toxicities were observed in 7 cases (3%) of the 232 cycles of ETI. Conclusion The ETI combination regimen shows comparatively low toxicity and modest activity in heavily pretreated recurrent or persistent EOC patients with more than 6 months of PFI after last platinum treatment.

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“…17 These two agents in the same or different combinations have also shown activity in relapsed pediatric solid tumors. 18 For relapsed ovarian tumors, combining the two agents together resulted in no responses in one Italian study, 22 whereas two other phase II trials reported 21% and 26% response rate. 23,24 Two of these phase II trials used intravenous etoposide, 22,23 while the recent one 24 used oral etoposide as we did in our study.…”

Section: Discussionmentioning

confidence: 99%

Phase II Study of Ifosfamide Plus Daily Oral Etoposide in Previously Treated Ovarian Cancer

Shaheen¹,

Stender²,

McClean³

et al. 2004

American Journal of Clinical Oncology

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Advanced epithelial ovarian carcinoma is a chemosensitive tumor to platinum plus paclitaxel combination chemotherapy. However, most patients develop recurrences following their initial platinum-based regimen and are candidates for subsequent chemotherapy. Several chemotherapeutic drugs have been tested as single therapeutic agents or in combination for relapsed epithelial ovarian carcinoma. The response rate has been modest with no obvious advantage to combination chemotherapy versus single agents. Both oral etoposide and ifosfamide have shown activity as single agents in pretreated patients. We completed a phase II study at the Hoosier Oncology Group utilizing oral etoposide plus ifosfamide in patients with relapsed ovarian epithelial carcinoma. Fourteen patients entered the study. Ifosfamide was given intravenously (IV) at a dose of 1.2 g/m2/d on days 1 to 4 with mesna 300 mg/m2 IV 15 minutes prior to and 4 and 8 hours after ifosfamide infusion. Etoposide was administered as 37.5 mg/m2/d orally on days 1 to 14. This regimen was repeated every 28 days until disease progression or for a maximum of 6 cycles. Grade III to IV granulocytopenia occurred in 9 patients (64%), with 2 neutropenic infections, but with no therapy-related deaths. Grade III to IV thrombocytopenia occurred in 3 patients (21%), and grade III to IV nausea and vomiting in 1 patient. No renal, pulmonary, hepatic, cardiac, or serious neurotoxicity was observed. Two patients (14%) achieved partial response, and additional 5 (35%) patients had stable disease. The 1-year survival probability using Kaplan-Meier analysis was 0.8. In this small sample-size trial, we did not demonstrate an advantage to this combination regimen compared to these or other single agents.

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Ifosfamide and Etoposide Salvage Treatment in Advanced Ovarian Cancer

Cited by 5 publications

References 8 publications

Phase II Study of Combination Chemotherapy with Etoposide and Ifosfamide in Patients with Heavily Pretreated Recurrent or Persistent Epithelial Ovarian Cancer

Phase II Study of Combination Chemotherapy with Etoposide and Ifosfamide in Patients with Heavily Pretreated Recurrent or Persistent Epithelial Ovarian Cancer

Retrospective Study of Combination Chemotherapy With Etoposide and Ifosfamide in Patients With Heavily Pretreated Recurrent or Persistent Epithelial Ovarian Cancer

Phase II Study of Ifosfamide Plus Daily Oral Etoposide in Previously Treated Ovarian Cancer

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