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. 1991 Jul;117(Suppl 4):S129–S134. doi: 10.1007/BF01613217

Subcutaneous continuous infusion of ifosfamide and cyclophosphamide in ambulatory cancer patients: bioavailability and feasibility

T Cerny 1,✉, A Graf 2, Ph Rohner 2, T Zeugin 2, K W Brunner 1, A Küpfer 2
PMCID: PMC12201490  PMID: 1795001

Abstract

The oxazaphosphorines ifosfamide (IFO) and cyclophosphamide (CTX) are standard alkylating agents. Both drugs show an increased therapeutic index when given as a fractionated dosage over several days. Maximal fractionation is achieved by continuous infusion. We have studied the feasibility and bioavailability of a subcutaneously (s.c.) administered isotonic and neutral (pH 7) solution of IFO (10 h up to 5 days infusion) and CTX (12–24 h infusion) in patients with advanced cancer. A portable disposable gas-driven infusor syringe was used for ambulatory patients. Our results show 90%–100% bioavailability of s.c. IFO and CTX. The isotonic solution of IFO and CTX (pH 7) showed no significant local toxicity (one local infection in 51 cycles) during or after s.c. administration of 33 cycles with IFO and 18 with CTX. Haematotoxicity of both drugs was equal after s.c. and i.v. application. For IFO-treated patients no uro- or neurotoxicity was observed. We conclude that this novel continuous s.c. oxazaphosphorine infusion over a prolonged period is a rational, well-tolerated and economic way of delivering this drug on an outpatient basis.

Key words: Bioavailability, Cancer, Ifosfamide, Cyclophosphamide, Subcutaneous

Abbreviations

IFO

ifosfamide

CTX

cyclophosphamide

AUC

area under the curve

Footnotes

Part of this work has been published in Ann Oncol 1:365–368 (1990) and is being included in the present paper with kind permission of the publisher (Kluwer Academic Publishers, The Netherlands). This work was supported in part by a grant of the Swiss National Science Foundation. We thank R. Stotzer for technical assistance, L. Dietrich, E. Hasler, and D. Rohrbach for help in treatment application, and M. Kappeler for medical illustration. The disposable portable infusion pumps were kindly provided by Disetronic AG, Switzerland

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