Fourteen-day infusion of ifosfamide in the management of advanced breast cancer refractory to protracted continuous infusion of 5-fluorouracil

Aims and background: Ifosfamide is an active drug in advanced breast cancer . Short-term continuous infusion schedules have been evaluated with encoura ging results. The aim of the study was to evaluate in patients with advance d breast cancer a 14-day infusion schedule previously tested at our center In soft tissue sarcomas. Methods: From July 1998 to February 2000, 26 consecutive patients with heav ily pretreated breast cancer, progressing during protracted continuous infu sion of fluorouracil, were treated with ifosfamide at the dose of 800 mg/m( 2)/day for 14 consecutive days by means of an elastomeric pump via an indwe lling Groshong catheter. The median age of the patients was 52 years (range , 32-67) and median PS was 1 (range, 1-3). AH patients were pretreated with anthracyclines or taxanes; the median number of chemotherapy lines in the metastatic phase was 2 (range, 1-4). Predominant metastatic sites were soft tissues in 5 patients, lung in 6, liver in 7 and serosal cavities in 3. Results: Twenty-four patients were assessable for response. Two complete re sponses and 2 partial remissions were noted, for an overall 16.6% response rate. The duration of responses was 3+, 5, 8 and 10 months, respectively. S tabilization or minor response was observed in 2 more patients. The main to xic effect was myelosuppression (grade 1-2 in 15 patients, grade 3-4 in 4), Other toxicities included nausea in 14 patients (grade 3 in 2) and grade 1 -2 vomiting in 2 patients. Hair loss or alopecia was universal. Conclusions: The regimen yielded some clinically useful responses with acce ptable toxicity. Its evaluation in less advanced cases appears to be warran ted.