ifosfamide + carboplatin + etoposide + cyclophosphamide

A multi-agent chemotherapy regimen that combines the platinum agent carboplatin, the topoisomerase II inhibitor etoposide, and the oxazaphosphorine alkylating agents ifosfamide and cyclophosphamide. Mechanistically, carboplatin forms DNA intra- and interstrand crosslinks to inhibit DNA replication and transcription; etoposide stabilizes the DNA-topoisomerase II cleavage complex causing double-strand breaks; ifosfamide and cyclophosphamide are prodrugs metabolized to phosphoramide mustard and acrolein derivatives that alkylate DNA and crosslink strands. This combination has been studied in pediatric and adult oncology settings, including Wilms tumor, neuroblastoma, and relapsed germ cell tumors, often in alternating blocks with other regimens and with supportive care such as mesna and hematopoietic support.

Other names

ICE plus cyclophosphamide