Efficacy and toxicity of ifosfamide/cyclophosphamide, carboplatin, and etoposide (ICE/CCE) chemotherapy with or without GM-CSF in relapsed or refractory Wilms' tumor. A single institution study

Purpose This trial evaluated the efficacy and toxicity of two intensive che motherapy(CT) regimens employing alkylating agents in relapsed Wilms' tumor . Design Twenty-nine consecutive patients with resistant or relapsed Wilms' t umor were treated in a non-random fashion on a phase II study with either C yclophosphamide-Carboplatin-Etoposide (CCE) or Ifosfamide-Carboplatin-Etopo side (ICE). Results Of twenty-three patients evaluable for tumor response after two cou rses of therapy, three achieved a complete response (CR), 15 a partial resp onse (PR), three had stable disease (SD) and two had progressive disease (P D). The corresponding response (CR + PR) for CCE was 83% and for ICE, 73%. Toxicity was primarily hematopoeitic and was similar between the two regime ns except for the occurrence of hypophosphatemia in 4/20 cycles of ICE vers us 0/31 cycles of CCE. Conclusions CCE and ICE are active regimens for the treatment of resistant and recurrent Wilms' tumor. Hemopoietic and organ toxicities other than hyp ophosphatemia are similar for the two regimens.