High-dose ifosfamide and etoposide with filgrastim for stem cell mobilization in patients with advanced ovarian cancer

High-dose chemotherapy combined with autologous peripheral blood stem cell transplantation has shown promise as treatment for recurrent or persistent epithelial ovarian cancer, We evaluated the stem cell mobilization regimen of high-dose ifosfamide plus etoposide in 32 patients with epithelial ovari an cancer, who had a positive second-look laparatomy or recurrent disease. Ifosfamide was given at 10 g/m(2) by continuous i,v, from days 1 to 3, Etop oside was given at 150 mg/m(2) every 12 h for six doses on days 1-3, Filgra stim was given at 10 mu g/kg/d s.c. from day 5 until the completion of peri pheral blood stem cell harvest. Fourteen of 32 patients had measurable or e valuable disease before mobilization therapy and were assessed for response . In nine (64%) of the 14 patients, treatment response was demonstrated, an d these patients received a second cycle of mobilization therapy. The targe t CD34(+) cell dose (>8 x 10(6) cells/kg) was achieved with a median of one apheresis (range 1-5), A median of 25.1 (range 8.0-122.5) x 10(6) CD34(+) cells/kg body weight was collected. Non-hematologic toxicity was limited to grade 2 renal dysfunction in one patient and grade 2 hepatic dysfunction i n three patients, In this patient group, high-dose ifosfamide plus etoposid e with filgrastim support was well tolerated, lead to successful stem cell harvest and had antitumor activity.