Combined carboplatin plus ifosfamide and cisplatin in patients with advanced ovarian carcinoma. A phase I-II study

Vito Lorusso, Bernardo Leone, Giovanni Di Vagno, Luigi Manzione, Sergio Palmeri, Carlos Vallejo, Mario MacHiavelli, Grazia Nacci, Domenico Bilancia, Vita Leonardi, Annamaria Catino, Giulio Gargano, Giuseppe Loverro, Luigi Selvaggi, Mario De Lena

Research output: Contribution to journalArticle

Abstract

Because of the relative lack of overlapping toxicity, carboplatin (PPL) and cisplatin (CDDP) can be easily combined for treatment of ovarian cancer to increase total platinum dose intensity. Ifosfamide (IFO), one of the most effective single agents in ovarian cancer, has a low hematological toxicity when administered in continuous infusion. From January 1991 to December 1993, 34 patients with advanced ovarian cancer, previously untreated with chemo- or radiotherapy, were enrolled in a phase I-II study with the aim of determining the maximum tolerated dose (MTD) of CDDP (on day 8 of a 28-day cycle) in combination with PPL (300 mg/m2 on day 1) and IFO (4,000 mg/m2/24 h by continuous infusion on day 1). The initial dose level of CDDP was 40 mg/m2, which was continuously increased by 10 mg/m2 up to the MTD defined as one dose level below that inducing dose-limiting toxicity (DLT) in at least two- thirds of treated patients; no dose escalation was allowed in the same patient. Grade 3-4 leukopenia and thrombocytopenia were observed in 54 and 49% of patients, respectively. The DLT was reached at 70 mg/m2 and therefore the dose recommended for the phase II study was 60 mg/m2. Complete (CR) plus partial response was observed in 88% of patients with a 21% pathological CR. With a minimum follow-up of 32 months (median 40 months), median progression- free survival and overall survival were 21 and 39 months, respectively. In conclusion, the combination of CDDP, PPL, and IFO provides an effective regimen for ovarian cancer with an acceptable toxicity profile.

Original languageEnglish
Pages (from-to)172-177
Number of pages6
JournalGynecologic Oncology
Volume68
Issue number2
DOIs
Publication statusPublished - Feb 1998

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

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    Lorusso, V., Leone, B., Di Vagno, G., Manzione, L., Palmeri, S., Vallejo, C., MacHiavelli, M., Nacci, G., Bilancia, D., Leonardi, V., Catino, A., Gargano, G., Loverro, G., Selvaggi, L., & De Lena, M. (1998). Combined carboplatin plus ifosfamide and cisplatin in patients with advanced ovarian carcinoma. A phase I-II study. Gynecologic Oncology, 68(2), 172-177. https://doi.org/10.1006/gyno.1997.4913