Ambulatory administration of 5-day infusion ifosfamide plus mesna: a pilot study in sarcoma patients

作者：Coriat Romain; Mir Olivier; Camps Sandra; Ropert Stanislas; Billemont Bertrand; Leconte Mahaut; Larousserie Frederique; Anract Philippe; Alexandre Jerome; Goldwasser Francois^*

来源：Cancer Chemotherapy and Pharmacology, 2010, 65(3): 491-495.

DOI：10.1007/s00280-009-1054-1

• Ifosfamide
• Mesna
• Chemotherapy
• Sarcoma
• Ambulatory
• Outpatient chemotherapy

Ifosfamide is a cornerstone of chemotherapy in bone and soft-tissue sarcoma. Results of pharmacokinetic studies indicate that the optimal schedule of ifosfamide should be repeated doses over several days. With the development of 5-day infusion devices, we developed and evaluated a 5-day infusion regimen of ifosfamide in sarcoma patients in the outpatient setting.
Sarcoma patients requiring chemotherapy after at least one doxorubicin-based line were enrolled in this study. Ifosfamide + mesna was administered as 1:1 concentration for a total of 6 g/m(2) of each over 5 days (i.e. 1.2 g/m(2) per day as continuous infusion) every 3 weeks. Patients were treated until progression or limiting toxicity, and salvage surgery was attempted when possible. An economic study was run comparing ifosfamide plus mesna as a 5-day infusion regimen and conventional Ifosfamide regimen.
Thirteen sarcoma patients were evaluable. The median number of cycles per patient was 6 (range, 1-8), for a total of 69 cycles. No acute encephalopathy or aggravation of renal function was noted. Acute grade 3 and 4 haematological toxicities were observed in 11.6 and 1.4% of patients, respectively without febrile neutropenia. Median time to progression survival and overall survival were 8.7 and 21.5 months, respectively. Total cost per cycle for a 2-mA(2) patient body surface area was ambulatory infusion = 1,891 a,not sign and conventional ifosfamide = 6,256 a,not sign.
The combination of ifosfamide and mesna as a continuous infusion over 5 days is feasible and well tolerated in the outpatient setting using infusion device. Its very favourable cost-effectiveness invites to further develop this approach.

• 出版日期2010-2