Ifosfamide. Methotrexate and 5-Fluorouracil for Pretreated Advanced Breast Cancer

Abstract

A total of 51 fully evaluable patients with advanced and intensively pretreated breast cancer were treated with a combination chemotherapy of ifosfamide plus mesna, methotrexate and 5-fiuorouracil. All patients had received at least one series of combined chemotherapy, 30 patients had received more than one combination and 41 patients had had anthracyclines before. Metastatic lesions in more than one site were found in 42 patients, and 24 patients had metastatic liver lesions. Partial remission was achieved in 10 patients (20%) and no change in 16 patients (31%). Survival was almost identical in both groups of responding patients and significantly shorter in treatment failures. Response was favorable in patients without pretreatment with anthracyclines. Two patients who received this protocol directly after progression with cyclophosphamide, methotrexate and 5-fiuorouracil (CMF protocol) responded with a partial remission. Median time to progression was 7 months for partial responders and 4.5 months for patients achieving a no-change status. Median survival was 8 months for all patients. Toxicity was tolerable. Leukocytopenia and thrombocytopenia were treatment-limiting parameters. Overall, this protocol is well tolerable and effective in breast cancer patients with advanced disease and in intensively pretreated patients.

Combined chemotherapy of murine mammary tumors by local activation of the prodrugs ifosfamide and 5-fluorocytosine

“…7). The synergistic interaction of the pharmacologically active metabolites of these SG/PD systems has been well established 8 and has been applied in combination chemotherapy for many years. CYP2B1 and CD have been shown not only to kill transfected cells but also to exert toxic effects on neighboring cells.…”

A Phase II study of paclitaxel by 24‐hour infusion and ifosfamide in anthracycline‐resistant metastatic breast carcinoma

“…Ifosfamide produces objective responses in 30 -40% of patients with MBC and 7-23% of patients with breast carcinoma pretreated with cyclophospha-mide-containing chemotherapy as a single agent. 21,22 Walters et al conducted a study similar to ours with regard to pretreatment chemotherapy. 23 Single-agent ifosfamide 2 g/m 2 was administered intravenously daily for 5 days to the patients mainly pretreated with cyclophosphamide and doxorubicin and reported a 7% (2 of 29) response rate.…”

Ifosfamide in Advanced/Disseminated Breast Cancer

“…Ifosfamide has been combined with methotrexate and 5-fluorouracil [11, 12], epirubicin [13, 14], mitoxantrone [15]and etoposide [16]. The patients were pretreated and the response rates varied from 20 to 45%.…”