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This high-dose sequential chemotherapy regimen was developed and investigated by the City of Hope Medical Center for the treatment of various advanced and refractory malignancies. The protocol is structured into two distinct intensive cycles: the first cycle consists of cisplatin, cyclophosphamide, and etoposide, followed by a second cycle comprising ifosfamide, carboplatin, and paclitaxel. Due to the supra-pharmacologic dosing intended to overcome tumor drug resistance, the regimen is administered in conjunction with autologous peripheral blood stem cell transplantation (ASCT) to rescue the patient from severe, treatment-induced myelosuppression. Supportive care typically includes filgrastim for hematopoietic recovery and mesna for uroprotection during ifosfamide administration. The regimen has been evaluated in a Phase I setting for advanced breast carcinoma, ovarian cancer, various sarcomas, and other solid tumors.
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