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Ifosfamide is an alkylating chemotherapy partnered with doxorubicin in sarcoma and with etoposide in Ewing sarcoma, given with a bladder-protecting drug.
Ifosfamide is an alkylating prodrug activated by CYP2B6 and CYP3A4 to a mustard that crosslinks DNA; its chloroacetaldehyde metabolite causes the characteristic encephalopathy and nephrotoxicity, and mesna uroprotection is mandatory to prevent haemorrhagic cystitis. Approved in 1988 for germ cell testicular cancer, it is standard off-label as the partner of doxorubicin in AIM for soft-tissue sarcoma, in MAP-IE for osteosarcoma, and with etoposide in VDC/IE for Ewing sarcoma, the regimen established by INT-0091. Febrile neutropenia occurred in 46% of patients on the AIM arm of EORTC 62012, encephalopathy in about 10% (treated with methylene blue) and haemorrhagic cystitis in about 5% even with mesna. It is a powerful alkylator whose use depends on protecting the bladder, kidneys and brain from its by-products.
Prodrug activated by CYP2B6/3A4 to an alkylating mustard causing DNA crosslinks; chloroacetaldehyde metabolite causes neuro- and nephrotoxicity.
1.Ifosfamide slips into a pocket on its target.
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. Generic; usually with mesna.
Multi-source generic; covered under the medical benefit without prior authorisation in most plans, as part of standard regimens.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
Sources: NICE search: ifosfamide. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
| Region | Year | Indication |
|---|---|---|
| US | 1988 | Germ cell testicular cancer; widely used off-label in sarcoma |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Febrile neutropenia (with doxorubicin) EORTC 62012 AIM arm | - | 46% |
| Encephalopathy | 10% | - |
| Haemorrhagic cystitis with mesna | 5% | - |
Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Read for the class this product belongs to (ifosfamide) unless the answer names the product. Population figures from the cohorts named, not a prediction for one person. Blank where no source gives a recovery figure.
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Query for this drug: (TITLE:"Ifosfamide" OR ABSTRACT:"Ifosfamide" OR TITLE:"Ifex" OR ABSTRACT:"Ifex") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Ifosfamide, not a curated reading list.
Shares Study of Pixantrone in CD20+ Relapsed/Refractory Aggressive Non-Hodgkin Lymphoma, Lance Armstrong, A Study to Evaluate Glofitamab Monotherapy and Glofitamab + Chemoimmunotherapy in Pediatric and Young Adult Participants With Relapsed/Refractory Matu, A Trial to Learn How Effective and Safe Odronextamab is Compared to Standard of Care for Adult Participants With Previously Treated Aggressive B-cell .
Shares INT-0091 (Ewing sarcoma), MASCT-I Combined With Doxorubicin and Ifosfamide for First-line Treatment of Advanced Soft Tissue Sarcoma, EORTC 62012, Pleuropulmonary blastoma (types I, Ir, II and III).
Shares EURAMOS-1, Myxofibrosarcoma, Malignant peripheral nerve sheath tumour (MPNST), Chondrosarcoma.
Shares Treatment Protocol of the NHL-BFM and the NOPHO Study Groups for Mature Aggressive B-cell Lymphoma and Leukemia in Children and Adolescents, Histological response to induction chemotherapy (osteosarcoma and Ewing sarcoma), Choriocarcinoma of the testis, International Collaborative Treatment Protocol For Children And Adolescents With Acute Lymphoblastic Leukemia.
Shares Pleuropulmonary blastoma (types I, Ir, II and III), ACNS0122, ACNS1123, AEWS0031.
Shares ISG-STS 1001, Myxofibrosarcoma, Retroperitoneal sarcoma, Undifferentiated pleomorphic sarcoma (UPS).
Shares INT-0091 (Ewing sarcoma), ACNS0122, ACNS1123, AEWS0031.
Shares Aldoxorubicin versus investigator's choice in relapsed or refractory soft tissue sarcoma, Desmoplastic small round cell tumour, Retroperitoneal sarcoma, Synovial sarcoma.