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Efficacy and tolerability of the ifosfamide–epirubicin combination in relapsed ovarian cancer
  1. F. Joly*,
  2. H. Bourgeois,
  3. A. Floquet,
  4. P. Chinet-Charrot§,
  5. F. Meyer,
  6. D. Lebrun,
  7. K. Hamond*,
  8. C. Leroy# and
  9. J. F. Heron*
  1. *Medical Oncology Department, Centre de Lutte contre le Cancer Francois Baclesse, Caen, France
  2. Medical Oncology Department, CHU Poitiers, Poitiers, France
  3. Medical Oncology Department, Centre de Lutte contre le Cancer Bergonié Bordeaux, Bordeaux, France
  4. §Medical Oncology Department, Centre de Lutte contre le Cancer Henry Becquerel Rouen, Rouen, France
  5. Medical Oncology Department, Centre de Lutte contre le Cancer Georges Francois Leclerc Dijon, Dijon, France
  6. Medical Oncology Department, Institut Jean Godinot Reims, Reims, France
  7. #Medical Oncology Department, CHR La Roche sur Yon, La Roche sur Yon, France
  1. Address correspondence and reprint requests to: Florence Joly, MD, PhD, Service d'oncologie médicale, Centre Francois Baclesse, Route de Lion sur Mer, BP 5026, 14076 Caen, Cedex 05, France. Email: f.joly{at}


A retrospective study evaluating the efficacy and tolerability of epirubicin–ifosfamide (EI) in patients with relapsed advanced ovarian cancer (ROC) after prior chemotherapy was conducted. A total of 93 patients received epirubicin (50 mg/m2, day 1), ifosfamide (1500 or 2500 mg/m2, days 1–3), and mesna monthly. Thirty-five percent had received one line of chemotherapy (platinum 100%, taxanes 8%); 38%, two lines; and 27%, more than two lines. Fifty-three percent received 2500 mg/m2/day ifosfamide and 47% received 1500 mg/m2/day ifosfamide. Ifosfamide was administered by continuous infusion in 12 patients. Mean number of courses was 4 (1–12). Grade 4 toxicity was 69% neutropenia and 12% thrombocytopenia. Three patients on high-dose ifosfamide as a short infusion had central nervous system dysfunction resulting in death. There were 84 assessable patients: 7 (8%), complete responses; 13 (15%), partial responses; and 20 (24%), stable disease. Median time to progression was 5 months (3 days to 36 months). The EI combination appears to be effective in ROC. However, toxicity with high-dose ifosfamide administered by short infusion is not acceptable. Tolerability can be improved using ifosfamide at 1500 mg/m2 by continuous infusion. The combination of ifosfamide with newer anthracycline agents such as liposomal doxorubicin may be an alternative and needs further evaluation for use after first-line taxane-based chemotherapy.

  • chemotherapy
  • epirubicin
  • ifosfamide
  • relapsed advanced ovarian cancer

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