Regarding the Children's Oncology Group AEWS1031 Trial for Ewing Sarcoma

Wang, Ji‐Gan; Wei, Qiufen; Tang, Qu-Mei

doi:10.1200/jco.21.02546

Cited by 2 publications

(5 citation statements)

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“…We agree with Wang et al 1 that outcomes as they relate to local control are an important aspect of therapy for patients with nonmetastatic Ewing sarcoma. The group of patients in which the effect of local control modalities can be assessed is a subpopulation of all patients who enroll, and the appropriate outcome measures are EFS and overall survival from the time of local control.…”

supporting

confidence: 90%

“…We appreciate the comments by Wang et al 1 and the opportunity to add further clarity to our recent article. 2…”

mentioning

confidence: 87%

“…Relative hazard rates and associated 95% CIs were calculated using an unstratified proportional hazards regression model. Wang et al 1 do make an important point regarding an opportunity for future analyses to identify possible prognostic factors for risk of an EFS event from the time of enrollment in the study data set. We plan to present such analyses in a subsequent report in the peer-reviewed literature.…”

mentioning

confidence: 99%

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Reply to J.-G. Wang et al

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Krailo

DuBois

et al. 2022

JCO

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We appreciate the comments by Wang et al 1 and the opportunity to add further clarity to our recent article. 2 We respectfully submit that the differences between the standard and experimental arms reflect the combination of vincristine/topotecan/cyclophosphamide (VTC) as reported since the VTC cassette was inserted as independent cycles into the standard 5-drug interval compressed regimen. Topotecan was administered at 0.75 mg/m 2 per dose, once daily for 5 days per topotecan containing cycle. Preclinical experience supports a synergistic effect between vincristine and topotecan, 3 and although topotecan alone was not considered active in Ewing sarcoma on the basis of single-agent testing, 4 data in recurrent Ewing sarcoma [5][6][7] clearly demonstrate the efficacy of this combination. In addition, although total alkylator dose delivery was near equal in both arms, the fractionated delivery of cyclophosphamide in the VTC cassette was also a notable difference.

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supporting

confidence: 90%

“…We appreciate the comments by Wang et al 1 and the opportunity to add further clarity to our recent article. 2…”

mentioning

confidence: 87%

mentioning

confidence: 99%

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Reply to J.-G. Wang et al

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Krailo

DuBois

et al. 2022

JCO

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“…Nonetheless, some studies have shown that increasing chemotherapy intensity did not improve Ewing sarcoma efficacy. 8 , 9 , 27 Chemotherapy occupied only one part in the multidisciplinary comprehensive treatment of Ewing sarcoma, and local control modalities had an important impact on long‐term survival. This study also explored the prognosis of different local control modalities and found that surgery combined with radiotherapy was significantly better than surgery alone or radiotherapy alone.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, some studies have shown that increasing chemotherapy intensity did not improve Ewing sarcoma efficacy 8,9,27 . Chemotherapy occupied only one part in the multidisciplinary comprehensive treatment of Ewing sarcoma, and local control modalities had an important impact on long‐term survival.…”

Section: Discussionmentioning

confidence: 99%

Long‐term follow‐up results of pediatric and adolescent patients with localized Ewing sarcoma treated based on stratified modalities

et al. 2023

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Background Compared with other pediatric tumors, little advances were achieved in studies on the stratified treatment in localized Ewing sarcoma. Most pediatric oncology groups treated Ewing sarcoma according to whether there was an existing metastasis, without involving more prognostic factors. In this study, patients with localized Ewing sarcoma were divided into resectable and unresectable groups at diagnosis and received chemotherapy with different intensity, for the purpose of achieving good efficacy, avoiding overtreatment and reducing unnecessary toxicity. Methods A total of 143 patients with a median age of 10 years old diagnosed with localized Ewing sarcoma in this retrospective study were divided into two cohorts (Cohort 1, n = 42; Cohort 2, n = 101) and patients in Cohort 2 received chemotherapy with different intensity (Regimen 1, n = 52; Regimen 2, n = 49). Outcomes were analyzed using the Kaplan–Meier method to estimate event‐free survival (EFS) and overall survival (OS), and the curves were compared using the log‐rank test. Results The 5‐year EFS and 5‐year OS for all the patients were 69.0% and 77.5%. The 5‐year EFS for Cohort 1 and Cohort 2 were 76.0% and 66.1% ( p = 0.31), and the 5‐year OS were 83.0% and 75.1% ( p = 0.30), respectively. In Cohort 2, the 5‐year EFS rate of patients treated with Regimen 2 was significantly higher than that of patients treated with Regimen 1 (74.5% vs. 58.3%, p = 0.03). Conclusions According to whether a grossly complete resection was received at the time of diagnosis, localized Ewing sarcoma patients in this study were stratified into two groups and received different intensities of chemotherapy, which achieved good efficacy and avoided overtreatment and reduced unnecessary toxicity.

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Regarding the Children's Oncology Group AEWS1031 Trial for Ewing Sarcoma

Cited by 2 publications

References 5 publications

Reply to J.-G. Wang et al

Reply to J.-G. Wang et al

Long‐term follow‐up results of pediatric and adolescent patients with localized Ewing sarcoma treated based on stratified modalities

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