A phase II study of ifosfamide and bleomycin in advanced or recurrent cervical carcinoma

Thirty-seven patients with advanced or recurrent cervical squamous cell carcinoma were treated with ifosfamide 1.5 g m(-2) on days 1-5 (with mesna as a uroprotector), and bleomycin 30 mg on day 1, every 3 weeks. A partial response rate of 21% (95% CI: 6-36%) was obtained in patients who had not received prior chemotherapy, with a median duration of response of 5 months. No complete responses were seen. The median survival of all patients was 6 months. Nausea and vomiting, white cell suppression and encephalopathy were the main toxic effects. The results suggest that the addition of bleomycin to ifosfamide is not advantageous and increases toxicity, and that the interaction between these two agents is not contributory to the activity of the bleomycin, ifosfamide and cisplatin combination regimen (BIP). The potentially more severe toxicity of combination regimens must be considered when treating this group of patients.