Survival After Recurrence of Ewing’s Sarcoma Family of Tumors

Barker, L.; Pendergrass, Thomas W.; Sanders, Jean E.; Hawkins, Douglas S.

doi:10.1200/jco.2005.05.105

Cited by 176 publications

(152 citation statements)

References 36 publications

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“…Many studies have been conducted to assess the benefit of this megachemotherapy. Some studies suggested an improvement in clinical outcomes, [37][38][39] whereas others did not. 40,41 In the current study, HDC with hematopoietic stem cell rescue failed to improve EFS significantly among high-risk patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Obata

Ueda

Kawai

et al. 2007

Cancer

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BACKGROUND.Ewing sarcoma family of tumors (ESFT) of bone is extremely rare in Japan. The objectives of the current study were to assess the clinical outcome and prognostic factors of patients with ESFT of bone in Japan and to compare them between Euro‐American and Japanese populations.METHODS.The authors conducted a retrospective analysis of 243 patients who were treated for ESFT of bone in Japan between 1981 and 2003. Local therapy was surgery in 35% of patients, surgery combined with radiotherapy in 40% of patients, radiotherapy alone in 22% of patients, and no local treatment in 3% of patients. All but 3 patients received various regimens of multidrug chemotherapy.RESULTS.The median patient age was 16 years. The primary disease sites were the trunk in 53% of patients and the extremities in 47% of patients. Forty‐one patients had metastases at presentation. The median follow‐up was 66 months. A univariate survival analysis demonstrated that patients who had metastases at presentation, primary site in the trunk, age ≥16 years, tumor size ≥10 cm, tumor that responded poorly to induction chemotherapy, and local treatment with radiotherapy alone had a significantly worse event‐free survival (EFS). A multivariate analysis further verified that the former 3 factors were significant adverse prognostic factors. Of 201 patients with localized disease, 45 patients who received current chemotherapy regimens that included ifosfamide and etoposide had a significantly better 5‐year EFS rate (67.6%) compared with other patients.CONCLUSIONS.The clinical outcome of patients with localized ESFT of bone in Japan has improved markedly with the use of current chemotherapy regimens that include ifosfamide and etoposide and has become comparable to the outcomes observed in other major series of Euro‐American patients. The prognostic factors are also almost identical. Cancer 2007 © 2007 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Obata

Ueda

Kawai

et al. 2007

Cancer

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“…Early exploratory studies with HDT followed by HSCT documented activity against refractory, large localized and disseminated EFT. 4,11,22 Mel has long been the most commonly used agent in HDT regimen for advanced, high-risk EFT. The French Society for Pediatric Oncology has reported excellent results in children with poor prognosis EFT who were treated with BU (600 mg/ m 2 /dose four times a day Â 4 days) and Mel (140 mg/m 2 , given as 70 mg/m 2 /day Â 2 days).…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] However, patients with bulky primary tumors, with multifocal or metastatic disease at presentation or with refractory or recurrent disease have a very poor prognosis, with only 10-30% survival rate at 3 years. [1][2][3][4] As some studies have shown that there is a positive linear relationship between the dose of cytoreductive agents and tumor response, 5 the approach of high-dose chemo-and/or radiation therapy followed by autologous hematopoietic SCT (HSCT) has been used in the practice of treatment of EFT in an attempt to improve the disease outcome and overall survival (OS) rate. We report our experience with further intensification of treatment in children and adolescents with high-risk EFT.…”

Section: Introductionmentioning

confidence: 99%

High-dose therapy with hematopoietic stem cell rescue in patients with poor prognosis Ewing family tumors

Rosenthal

Bolotin

Shakhnovits

et al. 2008

Bone Marrow Transplant

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The purpose of the study was to evaluate the feasibility and safety of two cycles of high-dose chemotherapy (HDT) followed by autologous hematopoietic SCT (HSCT) in patients with poor prognosis Ewing family of tumors (EFT). Twenty patients with primary metastatic bulky disease or recurrent EFT were enrolled to a treatment protocol with two cycles of HDT and HSCT. Patients tolerated well the first (n ¼ 20) and second (n ¼ 13) cycles, with limited and predictable toxicities. Only one (5%) TRM occurred during the second cycle. Myeloid engraftment occurred at the median of 11 days after both cycles. At 3 years, the overall and EFS were 45% (confidence interval; CI 0.22, 0.69) and 47% (CI 0.25, 0.70), respectively, for the entire group and 58% (CI 0.30, 0.86) for patients who completed two cycles. Dose intensification with two cycles of HDT and HSCT is feasible and safe, with low and acceptable treatmentrelated morbidity and mortality. Adding a second course of therapy does not impair engraftment. However, only 65% of the patients were able to proceed to the second cycle. Further studies are required to define the optimal mode of delivery of HDT and HSCT in treatment of advanced EFT.

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“…Approximately 95% of Ewing's sarcomas harbor the distinctive chromosome translocation t(11;22)(q24;q12) resulting in the characteristic EWS-FLI1 fusion gene [14], a potential therapeutic target recently explored [33]. Despite the improvements in adjuvant chemotherapy, radiotherapy, and surgery, 30% to 40% of patients with Ewing's sarcoma experience disease recurrence [7,10] with only a 23% 5-year overall survival rate [4]. Approximately 20% to 30% of children with Ewing's sarcoma present with metastatic disease at diagnosis [25].…”

Section: Introductionmentioning

confidence: 99%

Dendritic Cell-Ewing’s Sarcoma Cell Hybrids Enhance Antitumor Immunity

Guo

Tang

et al. 2008

Clin Orthop Relat Res

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Given the effective immunotherapy of DCbased vaccine in other cancers, we hypothesized DC-based vaccines would induce effective immune responses against Ewing's sarcoma. To verify this hypothesis and develop the most effective dendritic cell vaccine against Ewing's sarcoma, we evaluated the antitumor efficacy of dendritic cell-Ewing's sarcoma hybrids and dendritic cells pulsed with other antigen-loading methods, including cell lysates and the characteristic EWS-FLI1 gene of Ewing's sarcoma, using an A673 cell line as a model. The hybrids were generated by electrofusion with fusion efficiency and viability determined by flow cytometry and fluorescent microscopy analyses. By interferon-c secretion assay, the capacity of hybrids to stimulate cytotoxic T-lymphocytes (CTLs) is higher than that of other antigen-loading methods showing stronger tumor antigen-specific CTL cytotoxicity to A673. By in vivo experiment in SCID mice, all dendritic cell-based strategies induced specific immune responses to Ewing's sarcoma after mice-human immune system reconstitution by inoculating human peripheral blood mononuclear cells into the peritoneal cavity of SCID mice. However, the hybrids most inhibited the subcutaneous tumor growth in SCID mice compared with dendritic cells pulsed with other loading methods. The data suggest A673 cells respond to dendritic cell-based immunotherapy.

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Survival After Recurrence of Ewing’s Sarcoma Family of Tumors

Abstract: HDT as consolidation therapy for relapsed ESFT seems to be associated with improved OS, even after adjusting for RFI and response to second-line treatment.

Cited by 176 publications

References 36 publications

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

High-dose therapy with hematopoietic stem cell rescue in patients with poor prognosis Ewing family tumors

Dendritic Cell-Ewing’s Sarcoma Cell Hybrids Enhance Antitumor Immunity

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