Intensive-dose ifosfamide and etoposide with filgrastim for cytoreduction before peripheral blood stem cell collection in patients with advanced ovarian cancer

Objective: To evaluate the antitumor activity and toxic effects of intensive-dose ifosfamide plus etoposide with filgrastim given as stem cell mobilization therapy before high-dose chemotherapy for recurrent or persistent ovarian cancer. Methods: We studied 32 patients with epithelial ovarian cancer who had a positive second-look laparatomy or recurrent disease. Ifosfamide was given at 10 g/m² (total dose) by continuous infusion over 72 h; etoposide was given at 150 mg/m² in 2-h infusions every 12 h during the same 72-h period; and filgrastim was given at 10 μg/kg/day subcutaneous injection from day 5 through completion of stem cell harvest. Results: Nine (64%) of the 14 patients assessed responded to the treatment. The target stem cell dose was achieved with a median of 1 apheresis (range 1-5 aphereses). Nonhematologic toxicity was limited to grade 2 nephrotoxicity in one patient and grade 2 hepatic toxicity in three patients. Conclusions: In this patient group, intensive-dose ifosfamide plus etoposide with filgrastim was well tolerated and produced antitumor activity.