Mini ICE (ifosfamide, etoposid, carboplatinum) after the failure f anthracyclines and taxanes in metastatic breast cancer patients: single institution experience


Klin Onkol 2001; 14(6): 202-207.

Summary: Since February 1996 till April2001, 27 patients with advanced breast cancer (26 women and 1 man) either after the anthracyclines (4) or anthracyclines and taxanes failure (23) were treated with combination mini ICE (day 1 and 2: ifosfamide 1g/m2 1-hour i. v. infusion, carboplatinum 200mg/m2 1-hour i. v. infusion, etoposid 300mg/m2 22-hour i. v. infusion) administered every 4 weeks until unacceptable toxicíty or disease progression. All patients had histologically proven breast cancer, ECOG performance status 0 - 2, age 33-71(median 47). 12 patients received more than 2lines of chemotherapy prior thiS regimen. We assessed the response rate (RR), the time to progression (TTP), the survival (OS), the safety and toxicíty. Results: Now 27 patients are evaluable for the toxicity and response. No treatment related death occurred. Toxicity was assessed according to CTC NCI. The major dose limiting toxicity was hematologic. There were 15 episodes of febrile neutropenia observed, 50 grade 3 or 4 hematologic toxicity in 106 administered cycles. There were administered 66 cycles in the subset of 15 younger patients (under the age of 50) and 40 cycles in the subset of 12 older patients respectively. Growth factors were used in 12 patients. Grade 3 diarrhea occurred in 2 cycles. All patients had alopecia. Other grade 3 or 4 nonhematologic toxicity has not been observed. The overall response rate is 41 % including 9 PR (33%) and 2 CR (8%). Median TTP is 22 weeks [4-117] with 5 patients (19 %) remaining progression free more than 12 month. Median survival is 47 weeks [4-256] with 12 patients (44%) living more then 1 year and 3 (11%) living more then 2 years since the treatment had been started. Conclusion: This regimen has shown good activity but significant hematologic toxicity in advanced breast cancer patients pretreated with anthracyclines and taxanes. This combination is suitable for younger patients with good performance status.