Ifosfamide seven-day infusion for recurrent and cisplatin refractory ovarian cancer.

Background: The prognosis of advanced ovarian cancer is very poor, with about 15% of patients surviving at five years. Since most of these patients will relapse and/or progress while on therapy, effective salvage treatments are needed. A phase II trial was designed to evaluate the feasibility, toxicity, and response of a seven-day ambulatory continuous infusion of ifosfamide in patients with recurrent or chemoresistant advanced ovarian cancer.

Patients And Methods: Nineteen patients with progressive ovarian cancer following a cisplatin-based induction chemotherapy were treated with continuous infusion ifosfamide with mesna at 1 g/m2/d and 400 mg/m2/d, respectively, for seven days every 28 days.

Results: The overall response rate was 37%. Responses were observed both in patients who relapsed after induction chemotherapy (4/6) and in those who were resistant to cisplatin (3/13). Toxicity was mild and tolerable in these heavily pretreated patients.

Conclusion: Ifosfamide, when administered as a protracted continuous infusion is an active drug in ovarian cancer and can be safely administered in an out-patient setting. Toxicity is minor even in heavily pretreated patients. Responses are observed in cisplatin refractory ovarian cancer.