Comparison of N-acetylcysteine and mesna as uroprotectors with ifosfamide combination chemotherapy in refractory germ cell tumors

N. C. Munshi, Patrick Loehrer, S. D. Williams, C. Langefeld, G. Sledge, C. R. Nichols, B. J. Roth, A. Neuman, W. B. Walsh, Lawrence Einhorn

Research output: Contribution to journalArticle

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Abstract

From January 1983 through August 1988, 318 consecutive patients with refractory germ cell neoplasms were treated with ifosfamide-containing combination chemotherapy. The patients received ifosfamide at 1.2 gm/m2 day with cis-platin 20 mg/m2 day for 5 days and etoposide 75 mg/m2 day for 5 days or vinblastine 0.11 mg/kg on days 1 and 2 for each cycle. Of 277 evaluable patients, NAC was used as an uroprotector in the initial 86 patients while the latter 191 consecutive patients received mesna to reduce urothelial toxicity. Dosages of NAC was 2.0 gm po q 6 hr and for mesna 120 mg/m2 IV push prior to ifosfamide and then 1200 mg/m2/day as continuous infusion of 5 consecutive days. All patients received 3.0 liters of normal saline per day. The number of courses of chemotherapy given in the two groups were similar. Twenty-four of the 86 patients (27.9%) receiving NAC developed hematuria (13 patients - grade 1, 4 patients - grade 2, and 7 patients - grade 3 toxicity). While 8 out of 191 (4.2%) mesna patients developed hematuria (6 - grade 1 and 2 - grade 3) (p

Original languageEnglish (US)
Pages (from-to)159-163
Number of pages5
JournalInvestigational New Drugs
Volume10
Issue number3
DOIs
StatePublished - Aug 1992

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Mesna
Ifosfamide
Germ Cell and Embryonal Neoplasms
Acetylcysteine
Combination Drug Therapy
Hematuria
Vinblastine
Etoposide

Keywords

  • germ cell tumor
  • ifosfamide
  • mesna
  • N-acetyl-cysteine
  • uroprotectants

ASJC Scopus subject areas

  • Pharmacology
  • Molecular Medicine

Cite this

Comparison of N-acetylcysteine and mesna as uroprotectors with ifosfamide combination chemotherapy in refractory germ cell tumors. / Munshi, N. C.; Loehrer, Patrick; Williams, S. D.; Langefeld, C.; Sledge, G.; Nichols, C. R.; Roth, B. J.; Neuman, A.; Walsh, W. B.; Einhorn, Lawrence.

In: Investigational New Drugs, Vol. 10, No. 3, 08.1992, p. 159-163.

Research output: Contribution to journalArticle

Munshi, N. C. ; Loehrer, Patrick ; Williams, S. D. ; Langefeld, C. ; Sledge, G. ; Nichols, C. R. ; Roth, B. J. ; Neuman, A. ; Walsh, W. B. ; Einhorn, Lawrence. / Comparison of N-acetylcysteine and mesna as uroprotectors with ifosfamide combination chemotherapy in refractory germ cell tumors. In: Investigational New Drugs. 1992 ; Vol. 10, No. 3. pp. 159-163.
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