Ifosfamide in Urologic Cancer

The therapeutic activity of ifosfamide in urologic tumors has been reviewed. Ifosfamide has definite activity in nephroblastoma, where it represents the treatment of choice for children who are not cured by front-line chemotherapy, and for the adults who are diagnosed with this uncommon disease. Definite therapeutic activity has also been shown in patients with urothelial tract malignancies and it represents a major option for patients failing first-line cisplatin-based chemotherapy. However, promising results have been achieved in chemo-naïve patients in combination with taxanes or gemcitabine, though at the price of relevant toxicity. A modest activity has been shown by ifosfamide in renal cancer (including the sarcomatoid variant) and in hormone-refractory prostate cancer, which unfortunately respond poorly to cytotoxic chemotherapy. No results of ifosfamide in penile carcinoma are available so far.