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Summary Etoposide now ranks amongst the most important drugs for the treatment of primary or secondary resistant inoperable bronchogenic carcinoma as well as in patients with prior cardiac disease, since it can be combined with CCNU and vincristine for an outpatient therapeutic schedule, and with ifosfamide or cis -platinum for intensive hospital treatment. In the present study of a group of 38 patients with inoperable bronchogenic carcinoma of diverse histological types treated with etoposide plus ifosfamide resulted in: (a) an increase in the survival time in one very unfavorable patients group either with previous cardiac damage or intensive prior treatment; (b) no cross-resistance of etoposide and ifosfamide with the ACO regimen; (c) demonstration that use of Mesnum makes higher ifosfamide doses possible. Although this group of patients was inoperable and had prior heart damage, the prognosis was considerably improved.

Summary The efficacy of ifosfamide combination chemotherapy was studied in 164 patients, 94 with advanced testicular carcinoma and 70 with metastatic sarcoma. Ifosfamide was given at 40–60 mg/kg/day i.v. on five consecutive days every 3–4 weeks together with mesna prophylaxis with 8 mg/kg i.v. being used at 0, 4 and 8 h after ifosfamide administration. Of 70 sarcoma patients 57 were evaluable for response, of whom 49 had received prior chemotherapy. The overall response rate was 46% (26/57) including 3 complete (CR) and 14 partial remissions (PR). Ninety-four patients with germ cell tumours of the testis were treated. Of 16 seminoma patients 15 achieved CR or PR. Seventy-eight patients with nonseminomatous testicular cancer who had received previous chemotherapy were either treated with ifosfamide/etoposide ( n = 63, remission rate: 30%) or ifosfamide/cisplatin ( n = 15, CR + PR: 33%). These results indicate that ifosfamide alone or in combination is active in sarcomas, seminomas and teratomas and that further studies are warranted employing the drug in first-line regimens.

Zwischen Dezember 1973 und November 1978 wurden 31 Osteo-sarkompatienten mit einer Kombination aus Cyclophosphamid, Vincristin, Adriamycin und DTIC (CYVADIC) behandelt. 11 von 19 Patienten mit lokalis

Summary Forty-nine patients with small-cell bronchogenic carcinoma were treated with the cytostatic combination etoposide, methotrexate and CCNU at 6-week intervals. For 20 of these patients this was the first attempt at chemotherapy, while in 6 patients the treatment was an adjuvant therapy after induction of a complete remission. Twenty-three patients were primary therapeutic failures following other chemotherapeutic combinations or recurrences after complete remission. While the remission rates and survival times achieved with the primary therapy were somewhat lower than for comparable cytostatic combinations owing to the unfavourable patient selection, remissions of up to 46 weeks were achieved in the treatment of recurrent disease. Given the minor side effects, simultaneous radiotherapy was possible without problems. In the light of these results, the employment of this regimen with non-cross-resistant cytostatic combinations in the form of cyclically alternating induction therapy is a possibility to be considered.

Summary A total of 165 patients from the West German Tumor Center in Essen suffering from a malignant testicular tumor received treatment with etoposide alone or in combination. Since this was adjuvant therapy and no measurable tumor parameters were available at the time of etoposide administration in 92 patients, the efficacy of etoposide treatment could be analysed retrospectively in only 73 patients. Thirty-seven of these patients received treatment with etoposide alone (dosage usually 120 mg/m 2 p.o. days 1–5 every 4 weeks) and 36 received treatment with a combination of etoposide and ifosfamide (dosage: etoposide 120 mg/m 2 i.v. days 1, 3, 5 and ifosfamide 40 mg/kg i.v. days 1, 5 every 3–4 weeks) when prior treatment with cytostatics had not been able to achieve complete remission, or the tumors had recurred. In patients treated with etoposide alone a total response rate of 24.3% was observed. In contrast, remission of the tumor was achieved in 58.3% of the patients receiving the etoposide-ifosfamide combination. Despite prior comprehensive cytostatic treatment, etoposide was still effective in some patients with refractory malignant testicular tumors. This was especially true of the etoposide-ifosfamide combination, as ifosfamide showed little cross-resistance with the previously administered cytostatics.