Ifosfamide

Clinical trials are studying Ifosfamide in several cancer types, especially sarcomas, lymphomas, leukemia, germ cell tumors, and neuroblastoma. These studies look at how well treatment works, how safe it is, and which patient groups may benefit most. Many trials compare Ifosfamide-based regimens with other treatments or test it in combinations.

Table of Contents

Overview of Ifosfamide trials

These studies are testing Ifosfamide in different cancer treatment plans, mostly as part of combination therapy.[1] The trial data show a wide range of goals, including finding the best dose, checking safety, and comparing how well treatment works against standard care or other regimens.[2]

Cancer types being studied

Ifosfamide is being studied in trials for Ewing sarcoma, soft tissue sarcoma, osteosarcoma, lymphoma, leukemia, germ cell tumors, neuroblastoma, and penile squamous cell carcinoma.[3] Some studies focus on newly diagnosed disease, while others include relapsed, refractory, recurrent, or high-risk disease.[4]

Trial phases and study designs

The trial set includes Phase 1, Phase 2, Phase 3, and Phase 4 studies.[5] Phase 1 trials in the data mainly look at dose-finding, safety, and tolerability, while later phases focus more on treatment benefit and comparison with standard regimens.[6]

Most of the studies are interventional, which means the research team gives a treatment and then measures the results.[7] Several trials are randomized, meaning patients are assigned by chance to different treatment groups, so the treatments can be compared fairly.[8]

Who may take part

Eligibility depends on the trial and the cancer being studied.[9] Some trials include children and adolescents, some include young adults, and some include adults only.[10]

  • Children and adolescents: Several leukemia, lymphoma, neuroblastoma, and sarcoma trials are designed for younger patients.[11]

  • Adults: Some lymphoma, sarcoma, and germ cell tumor studies are aimed at adults with relapsed, refractory, or advanced disease.[12]

  • High-risk disease: Many studies select patients with a higher chance of relapse or poor outcome, such as high-risk Ewing sarcoma or high-risk osteosarcoma.[6]

  • Relapsed or refractory disease: Some trials include people whose cancer came back or did not respond well to earlier treatment.[13]

Main endpoints being measured

The most common endpoint is event-free survival, which means the time before a cancer-related event happens, such as relapse, progression, second cancer, or death.[14] Other common endpoints are disease-free survival, overall survival, and objective response rate.[15]

Some studies also measure treatment safety, including adverse effects, serious adverse effects, and dose-limiting toxicities, which are side effects that stop a dose from being increased further.[5] In a few trials, researchers also look at special outcomes such as acute skin toxicity during radiotherapy, immune reconstitution, histological response, or complete metabolic response.[16]

Selected trial examples

In the iEuroEwing trial, researchers are studying treatment optimization for people with Ewing sarcoma, including standard-risk, high-risk, and disseminated disease groups.[1] The main goals include improving event-free survival and testing maintenance treatment added to standard chemotherapy.[1]

In the AIEOP-BFM ALL 2017 trial, children and adolescents with acute lymphoblastic leukemia are being studied in several randomized questions, including whether extra therapy can improve event-free survival or disease-free survival in different risk groups.[2] This trial also measures non-response, relapse, second malignancy, death, and in one part, immune recovery.[2]

In the rEECur trial, patients with recurrent or primary refractory Ewing sarcoma are being compared across different chemotherapy regimens to find the best balance of efficacy, toxicity, and acceptability.[4] The main endpoint is event-free survival time.[4]

In the high-risk osteosarcoma study, patients aged 2 to 50 years are being treated with post-operative chemotherapy plus mifamurtide, and the main goal is to improve event-free survival.[6] The study measures relapse, progression, second malignancy, and death as events.[6]

In several lymphoma trials, Ifosfamide is part of salvage or combination treatment for relapsed or refractory disease, with outcomes such as response rate, progression-free survival, and event-free survival.[9] These studies include both adult and pediatric populations.[9]

What these trials mean for patients

For patients, these trials are trying to answer practical questions: which treatment works best, which treatment is safer, and which treatment gives the longest control of the cancer.[17] Because the studies are different, a person may be eligible for one trial but not another based on age, diagnosis, disease risk, and how the cancer responded to earlier treatment.[18] The trial data show that Ifosfamide is mainly being used as one part of a larger cancer treatment plan, not as a stand-alone study drug.[12]

Trial ID Phase Condition studied Status Enrollment
2022-501180-40-00Phase 3Ewing SarcomaAuthorised1424
NCT03643276Phase 3Acute lymphoblastic leukemia in children and adolescentsAuthorised5100
NCT06230224Phase 3B-Cell Non-Hodgkin’s LymphomaAuthorised256
2024-516078-31-00Phase 4Recurrent and Primary Refractory Ewing SarcomaAuthorised712
NCT03643133Phase 2High-risk osteosarcomaAuthorised315
2024-515245-42-00Phase 1GD2-positive Ewing sarcomaAuthorised18
NCT03206671Phase 3Mature aggressive B-cell lymphoma and leukemia in children and adolescentsAuthorised650
2024-518912-37-01Phase 2High-risk and very high-risk Ewing SarcomaAuthorised60
2022-501260-18-00Phase 2Relapsed/refractory Richter TransformationCompleted60
2022-501261-46-00Phase 2Relapsed/Refractory Burkitt LymphomaCompleted33
NCT04838652Phase 2First relapse or primary refractory classical Hodgkin lymphomaAuthorised29
2022-501456-28-00Phase 3Atypical teratoid/rhabdoid tumours (ATRT)Authorised308
2023-503423-25-00Phase 3Burkitt lymphomaAuthorised89
2023-504264-41-00Phase 1CD20 positive B-Cell Non-Hodgkin Lymphoma (NHL)Authorised77
NCT04623541Phase 1Lymphoma of B-cell originAuthorised555

Ongoing Clinical Trials on Ifosfamide

  • Study on Treosulfan and Melphalan for High-Risk Ewing Sarcoma Patients

    Not yet recruiting

    1 1 1
    Investigated diseases:
    Italy
  • Study on the Effectiveness and Safety of Odronextamab Compared to Standard Treatment in Adults with Relapsed or Refractory Aggressive B-cell Non-Hodgkin Lymphoma

    Not yet recruiting

    1 1 1 1
    Investigated diseases:
    Austria Belgium Czechia Germany Hungary Italy +4
  • Study on Melphalan and Drug Combination for Low and Intermediate Risk Neuroblastoma Patients

    Not yet recruiting

    1 1 1 1
    Investigated diseases:
    Germany
  • Study Comparing Chemotherapy with Paclitaxel, Ifosfamide, and Cisplatin versus High-Dose Chemotherapy with Paclitaxel and Drug Combination for Relapsed Germ Cell Tumors

    Not recruiting

    1 1 1 1
    Belgium Denmark France Germany Ireland Italy +2
  • Study on Retifanlimab, Doxorubicin, and Ifosfamide for Adults with Certain Types of Sarcoma in the Abdomen, Limbs, and Trunk

    Not recruiting

    1 1 1
    France
  • Study Comparing Rituximab with Drug Combination for Patients with Newly Diagnosed High-Risk Burkitt Lymphoma

    Not recruiting

    1 1 1 1
    Investigated diseases:
    Belgium The Netherlands
  • Study Comparing Polatuzumab Vedotin with Rituximab, Ifosfamide, Carboplatin, and Etoposide for Adults with Relapsed or Refractory Diffuse Large B-Cell Lymphoma

    Not recruiting

    1 1 1 1
    Austria Germany Spain
  • Study of Selinexor, Ifosfamide, Etoposide, and Dexamethasone for Patients with Relapsed or Refractory Peripheral T-cell Lymphomas

    Not recruiting

    1 1 1
    Italy
  • Study of Tisagenlecleucel for Adults with Relapsed or Refractory Aggressive B-cell Non-Hodgkin Lymphoma

    Not recruiting

    1 1 1 1
    Austria France Germany Italy The Netherlands Norway +1
  • Study on Improving Treatment for Children and Adolescents with Acute Lymphoblastic Leukemia Using Bortezomib, Blinatumomab, and a Drug Combination

    Not recruiting

    1 1 1 1
    Austria Czechia Germany Italy Slovakia

Glossary

  • Phase 1: An early trial phase that mainly checks safety, tolerability, and sometimes the best dose for later studies.
  • Phase 2: A study phase that looks more closely at whether a treatment works and how safe it is in a specific disease group.
  • Phase 3: A larger trial phase that compares treatments to see which one works better or is safer.
  • Phase 4: A later study phase done after a treatment is already in wider use, often to learn more about real-world effectiveness.
  • Interventional study: A trial where researchers give a treatment and then measure the results.
  • Event-free survival (EFS): The length of time after treatment starts before a disease-related event happens, such as relapse, progression, second cancer, or death.
  • Disease-free survival (DFS): The length of time a patient stays free from disease after treatment, before relapse, second cancer, or death.
  • Overall survival (OS): The length of time from a study point until death from any cause.
  • Objective response rate (ORR): The percentage of patients whose tumors shrink or disappear enough to count as a response.
  • Complete response (CR): No signs of cancer seen on testing after treatment.
  • Partial response (PR): The cancer gets smaller, but does not disappear completely.
  • Randomization: A method that assigns patients by chance to different treatment groups.

References

  1. https://clinicaltrials.gov/study/2022-501180-40-00
  2. https://clinicaltrials.eu/trial/study-on-improving-treatment-for-children-and-adolescents-with-acute-lymphoblastic-leukemia-using-bortezomib-blinatumomab-and-a-drug-combination/
  3. https://clinicaltrials.eu/trial/study-on-the-effectiveness-and-safety-of-odronextamab-compared-to-standard-treatment-in-adults-with-relapsed-or-refractory-aggressive-b-cell-non-hodgkin-lymphoma/
  4. https://clinicaltrials.gov/study/2024-516078-31-00
  5. https://clinicaltrials.gov/study/2024-515245-42-00
  6. https://clinicaltrials.eu/trial/study-on-mifamurtide-with-chemotherapy-for-patients-with-high-risk-osteosarcoma/
  7. https://clinicaltrials.gov/study/2024-518912-37-01
  8. https://clinicaltrials.gov/study/2023-503423-25-00
  9. https://clinicaltrials.gov/study/2023-504264-41-00
  10. https://clinicaltrials.eu/trial/study-on-irinotecan-and-drug-combination-for-children-and-adults-with-frontline-and-relapsed-rhabdomyosarcoma/
  11. https://clinicaltrials.eu/trial/study-on-lymphoblastic-lymphoma-treatment-in-children-and-adolescents-using-dexamethasone-prednisone-and-peg-asparaginase/
  12. https://clinicaltrials.eu/trial/study-comparing-chemotherapy-with-paclitaxel-ifosfamide-and-cisplatin-versus-high-dose-chemotherapy-with-paclitaxel-and-drug-combination-for-relapsed-germ-cell-tumors/
  13. https://clinicaltrials.eu/trial/study-of-drug-combination-therapy-in-children-and-adolescents-with-relapsed-or-refractory-b-cell-non-hodgkin-lymphoma-using-odronextamab-loncastuximab-tesirine-and-rituximab/
  14. https://clinicaltrials.eu/trial/study-on-rituximab-and-drug-combination-for-treating-aggressive-b-cell-lymphoma-and-leukemia-in-children-and-adolescents/
  15. https://clinicaltrials.eu/trial/study-of-pembrolizumab-with-chemotherapy-for-patients-with-relapsed-or-refractory-classical-hodgkin-lymphoma/
  16. https://clinicaltrials.gov/study/2024-513437-21-00
  17. https://clinicaltrials.gov/study/2023-505040-19-00
  18. https://clinicaltrials.gov/study/2024-517295-37-00