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Ewing Sarcoma: Current Management and Future Approaches Through Collaboration

Lookup NU author(s): Emeritus Professor Alan Craft

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Abstract

© 2015 by American Society of Clinical Oncology. Ewing sarcoma (ES) is an aggressive sarcoma of bone and soft tissue occurring at any age with a peak incidence in adolescents and young adults. The treatment of ES relies on a multidisciplinary approach, coupling risk-adapted intensive neoadjuvant and adjuvant chemotherapies with surgery and/or radiotherapy for control of the primary site and possible metastatic disease. The optimization of ES multimodality therapeutic strategies has resulted from the efforts of several national and international groups in Europe and North America and from cooperation between pediatric and medical oncologists. Successive first-line trials addressed the efficacy of various cyclic combinations of drugs incorporating doxorubicin, vincristine, cyclophosphamide, ifosfamide, etoposide, and dactinomycin and identified prognostic factors now used to tailor therapies. The role of high-dose chemotherapy is still debated. Current 5-year overall survival for patients with localized disease is 65% to 75%. Patients with metastases have a 5-year overall survival < 30%, except for those with isolated pulmonary metastasis (approximately 50%). Patients with recurrence have a dismal prognosis. The many insights into the biology of the EWS-FLI1 protein in the initiation and progression of ES remain to be translated into novel therapeutic strategies. Current options and future approaches will be discussed.


Publication metadata

Author(s): Gaspar N, Hawkins DS, Dirksen U, Lewis IJ, Ferrari S, Le Deley M-C, Kovar H, Grimer R, Whelan J, Claude L, Delattre O, Paulussen M, Picci P, Hall KS, Van Den Berg H, Ladenstein R, Michon J, Hjorth L, Judson I, Luksch R, Bernstein ML, Marec-Berard P, Brennan B, Craft AW, Womer RB, Juergens H, Oberlin O

Publication type: Review

Publication status: Published

Journal: Journal of Clinical Oncology

Year: 2015

Volume: 33

Issue: 27

Pages: 3036-3046

Print publication date: 20/09/2015

Online publication date: 24/08/2015

Acceptance date: 01/01/1900

ISSN (print): 0732-183X

ISSN (electronic): 1527-7755

Publisher: American Society of Clinical Oncology

URL: http://doi.org/10.1200/JCO.2014.59.5256

DOI: 10.1200/JCO.2014.59.5256

PubMed id: 26304893


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