Dr. Robert A. Nagourney, MD
PROGRESS IN CHILDHOOD SARCOMA – HIGH-DOSE IFOSFAMIDE
An ASCO Plenary Session reported that high-dose ifosfamide was superior to the combination of cyclophosphamide plus topotecan in Ewing sarcoma, a form of childhood sarcoma.
The standard of care has generally been from among several drug combinations including cyclophosphamide plus topotecan, widely used since its introduction in 2001. These results indicate that Ifosfamide is the new standard of care, with improved median overall survival of 15.4 months versus 10.5 months.
As Ifosfamide is a drug that works by damaging DNA the findings suggest DNA damage repair deficiencies may be present in Ewing’s sarcoma.
We have studied many Ewing’s sarcomas as the disease often recurs after initial therapy. Ewing sarcomas vary in their sensitivity but gemcitabine or topotecan-based therapies may now be of use in the recurrent disease setting. The advantage of our laboratory studies is that they allow us to test all of the single agents and combinations simultaneously.