China
Africa
Explore chapters and articles related to this topic
Drug Delivery
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Gudrun Fleischhack, Martin Garnett, Kévin Beccaria
Trofosfamide is an oral oxazaphosphorine which is metabolized by dechloroethylation to ifosfamide and by 4-hydroxylation as main metabolic pathways.36 It has been used as a single drug or in drug combination mainly as maintenance or metronomic therapy in soft-tissue sarcomas and CNS tumors in children and in carcinomas and lymphomas in adults. In this setting trofosfamide has demonstrated some efficacy and low toxicity, which make it attractive for an oral palliative chemotherapy.37–39
Managing the risk of toxicity in the treatment of elderly patients with soft tissue sarcomas
Published in Expert Opinion on Drug Safety, 2021
Samia Arifi, Anastasia Constantinidou, Robin L. Jones
Oral trofosfamide, an oxazaphosphorine prodrug, has been tested in a randomized phase II trial in elderly patients with untreated metastatic STS [31]. A total of 120 patients were enrolled. The median age was 70 years (60–89). Eighty five percent had an ECOG PS of 0 or 1. Safety analyses revealed a favorable safety profile for trofosfamide. Grade 3 or 4 side-effects were lower in trofosfamide arm (59% vs 30.3% p = 0.005). Trofosfamide caused more grade 1 or 2 dyspnea and fatigue. No hemorrhagic cystitis, nephrotoxicity, or higher grade of neurotoxicity have been reported. The 60-day mortality rate was 8% in both arms. Of note, approximately 10% of patients received trofosfamide for more than 1 year. In terms of efficacy, the primary end-point was met. The 6-month progression free rate determined to be 27.6% (95% CI: 18–39.1%).
Different approaches to advanced soft tissue sarcomas depending on treatment line, goal of therapy and histological subtype
Published in Expert Review of Anticancer Therapy, 2020
Javier Martín-Broto, Peter Reichardt, Robin L Jones, Silvia Stacchiotti
In January 2008, and subsequent to a severe cough lasting months, pulmonary lesions were detected and histologically confirmed as synovial sarcoma. Anthracycline-based chemotherapy commenced in February 2008 but was discontinued after four cycles due to general seizures. The pulmonary metastases were resected. Upon recurrence of lung metastases, the patient elected to receive oral chemotherapy (trofosfamide) which slowed disease progression. Multiple bone metastases were managed with a bisphosphonate. Due to substantial progression of lung metastases and symptomatic involvement of the spinal cord, he received RT.