Description:
<jats:p><i>Background:</i> Oral mesna allows investigation of ifosfamide as a prolonged ambulatory infusion for dose-intense out-patient use. <i>Methods:</i> Cohorts of 3 patients received escalating doses of ifosfamide from 200 to 1,000 mg/m<sup>2</sup>/day as continuous ambulatory infusion with oral mesna at 30% of the ifosfamide dose every 6 h commencing 2 h prior to ifosfamide infusion as uroprotection on a 14-day schedule with cycles repeated every 28 days. <i>Results:</i> Fifteen patients received a median of three cycles.Dose-limiting toxicities with cycle 1 were lethargy and hepatotoxicity at 1,000 mg/m<sup>2</sup>/14 days. Transient transaminase elevation was seen at all dose levels. The other grade 3 toxicities were single episodes of anaemia, granulocytopenia, nausea and hypotension. The best response was stable disease in a patient with thyroid cancer. <i>Conclusion:</i> Ambulatory infusion of 600 mg/m<sup>2</sup> ifosfamide with 180 mg/m<sup>2</sup> oral mesna was considered suitable for phase II trials and delivers dose-intense out-patient therapy without urotoxicity.</jats:p>