J Clin Oncol: Phase III clinical trial results of vincristine-topotecan-cyclophosphamide for the initial treatment of non-metastatic Ewing's sarcoma

Ewing's sarcoma (EWS) is a rare malignant tumor in children , and its prognosis has been gradually improved due to its continuously adjusted and perfect conventional chemotherapy
.

Most notably, when the combination of etoposide and ifosfamide was included in the 17-course chemotherapy regimen, the patient’s survival rate was significantly improved; moreover, in the 14-course regimen, the treatment interval was compressed to The patient’s productivity was further improved when the dose enhancement was achieved in 2 weeks

Ewing sarcoma (EWS) is a rare children's cancer, which constantly adjust and improve the prognosis of conventional chemotherapy, it has also been a gradual improvement of the child

Recently, a new phase III randomized controlled trial published in the Journal of Clinical Oncology, the main purpose of which is to clarify whether the addition of vincristine, topotecan and cyclophosphamide (VTC) to interval compression chemotherapy can improve previously untreated The survival prognosis of patients with non-metastatic Ewing sarcoma
.

Whether adding vincristine, topotecan and cyclophosphamide (VTC) to interval compression chemotherapy can improve the survival prognosis of patients with previously untreated non-metastatic Ewing sarcoma

The test patients were randomized to receive standard five-dose interval intensive chemotherapy (plan A, 17 courses) or an experimental regimen (interleaved with 5 courses of VTC among the 17 standard regimens; plan B)
.

The stratification was carried out according to the age (<18 years or ≥18 years) and tumor location (pelvic bone, non-pelvic bone and extraosseous bone) of the tested patients at the time of diagnosis

EFS and OS of standard group and experimental group

A total of 642 patients were recruited, of which 309 received standard treatment and 320 received experimental treatment
.

The 5-year event-free survival rate (EFS) and overall survival rate (OS) of the total study patients were 78% and 87%, respectively

There is no significant difference in survival prognosis between the two treatment groups.

EFS and OS stratified by age

Age and primary site do not affect the risk of EFS events
.

However, age ≥18 at diagnosis is associated with a higher risk of death at 5 years (hazard ratio 1.

Age at diagnosis ≥ 18 years is associated with a higher risk of death at 5 years .

EFS stratified by tumor volume

All in all, adding VTC to the five-drug interval compression chemotherapy regimen cannot further improve the survival rate of patients with Ewing's sarcoma

Original source:

Original source:

Patrick J.

Phase III Trial Adding Vincristine-Topotecan- Cyclophosphamide to the Initial Treatment of Patients With Nonmetastatic Ewing Sarcoma: A Children's Oncology Group Report in this message