IFOSFAMIDE AND ETOPOSIDE IN PREVIOUSLY TREATED PATIENTS WITH ADVANCEDBREAST-CANCER

Aims and background: Ifosfamide is an active alkylating agent in the t reatment of breast cancer, as a first-line therapy and in advanced dis ease. Since the combination of etoposide with an alkylating agent prod uces a synergistic and tolerable activity in various malignancies, in the present study, ifosfamide and etoposide were administered to patie nts with advanced breast cancer to evaluate the response characteristi cs and the toxicity profile. Study design: The combination of ifosfami de, mesna and etoposide was prospectively administered to 41 previousl y treated patients with stage IV breast carcinoma. The treatment sched ule consisted of ifosfamide, 1500 mg/m(2), infused over 24 hrs with 15 00 mg/m(2) mesna on days 1 to 5 and 120 mg/m2 etoposide, infused over 1 hr on days 1 to 3, to be repeated every 4th week. Results: After a m edian follow-up of 10 months, an objective response rate of 23% (overa ll 2.5% complete remission and 20.5% partial remission) and a median r esponse duration of 5.3 months were obtained in 39 assessable patients . The non responder group consisted of 28.3% stable disease and 48.7% progressive disease. The prior status of chemotherapy was the only sig nificant prognostic factor with an impact on the response rate. The ov erall toxicity was generally mild, with grade 3 myelotoxicity encounte red in 25.7% of patients. Conclusions: The tolerable side effect profi le of the ifosfamide and etoposide combination might be advantageous a s regards the quality of life, To improve the rate and/or the duration of response and to clarify the precise role of the ifosfamide-etoposi de combination in previously treated advanced breast cancer, further t rials are warranted.