Difference between revisions of "Ewing sarcoma, pediatric"

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[[#top|Back to Top]]
 
[[#top|Back to Top]]
 
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{{#lst:Section editor transclusions|peds-sarcoma}}
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{{#lst:Editorial board transclusions|peds-sarcoma}}
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''Are you looking for a regimen, but can't find it here? It is possible that we've moved it to the [[Ewing Sarcoma_-_historical|historical regimens page]]. If you still can't find it, please let us know so we can add it!''
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<big>''This page contains studies that were specific to pediatric populations. For the more general Ewing sarcoma page, follow [[Ewing sarcoma|this link]].</big>
 +
<br>''Are you looking for a regimen, but can't find it here? It is possible that we've moved it to the [[Ewing_sarcoma,_pediatric_-_historical|historical regimens page]]. If you still can't find it, please let us know so we can add it!''
 
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{| class="wikitable" style="float:right; margin-right: 5px;"
 
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|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
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|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
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<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
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<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
 
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{{TOC limit|limit=4}}
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=Upfront Therapy=
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=Upfront therapy=
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==COG AEWS1031==
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==COG AEWS1031 Regimen A==
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===Regimen A Induction===
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<div class="toccolours" style="background-color:#c8a2c8">
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*Regimen A is a standard regimen consisting of 14 day cycles
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{| class="wikitable sortable" style="width: 100%; text-align:center;"
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====Chemotherapy, VDC portion====
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!style="width: 20%"|Study
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*[[Vincristine (Oncovin)]] as follows:
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!style="width: 20%"|Dates of enrollment
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**Cycles 1, 3, 5: 1.5 mg/m<sup>2</sup>/dose IV push once on day 1 of weeks 1, 2, 5, 6, 9 & 10 (maximum dose of 2 mg)
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!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
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***For children < 10 kg or < 1 year, the dose is 0.05 mg/kg/dose
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!style="width: 20%"|Comparator
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*[[Doxorubicin (Adriamycin)]] as follows:
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!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
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**Cycles 1, 3, 5: 37.5 mg/m<sup>2</sup>/dose IV push/infusion over 1-15 minutes on days 1 and 2 of weeks 1, 5 and 9.
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|-
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***For children < 10 kg or < 1 year, the dose is 1.25 mg/kg/dose
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|[http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8677904/ Leavey et al. 2021 (COG AEWS1031)]
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***Administer at a concentration not to exceed 2 mg/mL. [[Doxorubicin (Adriamycin)]] should be administered through the tubing of rapidly infusing solution of D5W or 0.9% NaCl, and it should not be infused into a large vein
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|2010-11-22 to 2016-01-04
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*[[Cyclophosphamide (Cytoxan)]] as follows:
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| style="background-color:#1a9851" |Phase 3 (C)
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**Cycles 1, 3, 5: 1200 mg/m<sup>2</sup>/dose IV over 30 to60 minutes on day 1 of weeks 1, 5 and 9
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|[[#COG_AEWS1031_Regimen_B_999|COG AEWS1031 Regimen B]]
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***For children < 10 kg or < 1 year, the dose is 40 mg/kg/dose
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| style="background-color:#ffffbf" |Did not meet co-primary endpoints of EFS/OS
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|-
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|}
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''Note: Regimen A is a standard 17-week regimen consisting of induction and continuation.''
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Induction===
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy, VDC portion (cycles 1, 3, 5)====
 +
*[[Vincristine (Oncovin)]] by the following age- and weight-based criteria:
 +
**10 kg or more AND 12 months old or older: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push once per day on days 1 & 8
 +
**Less than 10 kg OR younger than 12 months old: 0.05 mg/kg IV push once per day on days 1 & 8
 +
*[[Doxorubicin (Adriamycin)]] by the following age- and weight-based criteria:
 +
**10 kg or more AND 12 months old or older: 37.5 mg/m<sup>2</sup> IV push/infusion over 1 to 15 minutes once per day on days 1 & 2
 +
**Less than 10 kg OR younger than 12 months old: 1.25 mg/kg IV push/infusion over 1 to 15 minutes once per day on days 1 & 2
 +
***Administer at a concentration not to exceed 2 mg/mL. Doxorubicin should be administered through the tubing of rapidly infusing solution of D5W or 0.9% NaCl, and it should not be infused into a large vein
 +
*[[Cyclophosphamide (Cytoxan)]] by the following age- and weight-based criteria:
 +
**10 kg or more AND 12 months old or older: 1200 mg/m<sup>2</sup> IV over 30 to 60 minutes once on day 1
 +
**Less than 10 kg OR younger than 12 months old: 40 mg/kg IV over 30 to 60 minutes once on day 1
 
***May be administered as undiluted drug (20 mg/mL, reconstitute with 0.9% NaCl to avoid hypotonic solution) or further diluted
 
***May be administered as undiluted drug (20 mg/mL, reconstitute with 0.9% NaCl to avoid hypotonic solution) or further diluted
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====Supportive medications, VDC portion====
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====Supportive therapy, VDC portion (cycles 1, 3, 5)====
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*[[Mesna (Mesnex)]] as follows:
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*[[Mesna (Mesnex)]] by the following age- and weight-based criteria:
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**Cycles 1, 3, 5: 720 mg/m<sup>2</sup>/day by IV infusion or IV/PO with [[Cyclophosphamide (Cytoxan)]] on day 1 of weeks 1, 5 and 9
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**10 kg or more AND 12 months old or older: 720 mg/m<sup>2</sup> IV infusion or IV/PO with cyclophosphamide once on day 1
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***For children < 10 kg or < 1 year, the dose is 24 mg/kg/dose
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**Less than 10 kg OR younger than 12 months old: 24 mg/kg IV infusion or IV/PO with cyclophosphamide once on day 1
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====Chemotherapy, IE portion (cycles 2, 4, 6)====
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====Chemotherapy, IE portion====
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*[[Ifosfamide (Ifex)]] by the following age- and weight-based criteria:
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*[[Ifosfamide (Ifex)]] as follows:
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**10 kg or more AND 12 months old or older: 1800 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 to 5
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**Cycles 2, 4, 6: 1800 mg/m<sup>2</sup>/dose IV infusion over 1 hour on days 1, 2, 3, 4, and 5 of Weeks 3, 7 and 11
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**Less than 10 kg OR younger than 12 months old: 60 mg/kg IV over 60 minutes once per day on days 1 to 5
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***For children < 10 kg or < 1 year, the dose is 60 mg/kg/dose
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***Achieve urine specific gravity less than or equal to 1.010 before starting ifosfamide.
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***Achieve urine specific gravity ≤ 1.010 prior to start of [[Ifosfamide (Ifex)]].
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*[[Etoposide (Vepesid)]] by the following age- and weight-based criteria:
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*[[Etoposide (Vepesid)]] as follows:
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**10 kg or more AND 12 months old or older: 100 mg/m<sup>2</sup> IV over 1 to 2 hours once per day on days 1 to 5
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**Cycles 2, 4, 6: 100 mg/m<sup>2</sup>/dose IV infusion over 1 to 2 hours once on days 1, 2, 3, 4, and 5 of weeks 3, 7 and 11
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**Less than 10 kg OR younger than 12 months old: 3.3 mg/kg IV over 1 to 2 hours once per day on days 1 to 5
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***For children < 10 kg or < 1 year, the dose is 3.3 mg/kg/dose
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====Supportive therapy, IE portion (cycles 2, 4, 6)====
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====Supportive medications, IE portion====
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*[[Mesna (Mesnex)]] by the following age- and weight-based criteria:
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*[[Mesna (Mesnex)]] as follows:
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**10 kg or more AND 12 months old or older: 1080 mg/m<sup>2</sup> IV infusion or IV/PO with ifosfamide once per day on days 1 to 5
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**Cycles 2, 4, 6: 1080 mg/m<sup>2</sup>/day by IV infusion or IV/PO with ifosfamide on days 1, 2, 3, 4, and 5 of Weeks 3, 7 and 11
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**Less than 10 kg OR younger than 12 months old: 36 mg/kg IV infusion or IV/PO with ifosfamide once per day on days 1 to 5
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***For children < 10 kg or < 1 year, the dose is 36 mg/kg/dose
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'''14-day cycle for 6 cycles, followed by continuation (to be completed):'''
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'''14-day cycle for 6 cycles'''
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</div></div></div>
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===Regimen A Consolidation===
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===References===
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===Regimen B Induction===
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#'''COG AEWS1031:''' Leavey PJ, Laack NN, Krailo MD, Buxton A, Randall RL, DuBois SG, Reed DR, Grier HE, Hawkins DS, Pawel B, Nadel H, Womer RB, Letson GD, Bernstein M, Brown K, Maciej A, Chuba P, Ahmed AA, Indelicato DJ, Wang D, Marina N, Gorlick R, Janeway KA, Mascarenhas L. Phase III Trial Adding Vincristine-Topotecan-Cyclophosphamide to the Initial Treatment of Patients With Nonmetastatic Ewing Sarcoma: A Children's Oncology Group Report. J Clin Oncol. 2021 Dec 20;39(36):4029-4038. Epub 2021 Oct 15. Erratum in: J Clin Oncol. 2022 Jul 20;40(21):2393. [https://doi.org/10.1200/jco.21.00358 link to original article] [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8677904/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/34652968/ PubMed] [https://clinicaltrials.gov/study/NCT01231906 NCT01231906]
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===Regimen B Consolidation===
 
−
 
 
 
[[Category:Ewing sarcoma regimens]]
 
[[Category:Ewing sarcoma regimens]]
 
[[Category:Disease-specific pages]]
 
[[Category:Disease-specific pages]]
 
[[Category:Bone sarcomas]]
 
[[Category:Bone sarcomas]]
 
[[Category:Pediatric solid tumors]]
 
[[Category:Pediatric solid tumors]]

Revision as of 16:52, 3 May 2024

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Section editor
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If you are interested in this role, please contact us at [email protected].

This page contains studies that were specific to pediatric populations. For the more general Ewing sarcoma page, follow this link.
Are you looking for a regimen, but can't find it here? It is possible that we've moved it to the historical regimens page. If you still can't find it, please let us know so we can add it!

0 regimens on this page
0 variants on this page


Upfront therapy

COG AEWS1031 Regimen A

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Leavey et al. 2021 (COG AEWS1031) 2010-11-22 to 2016-01-04 Phase 3 (C) COG AEWS1031 Regimen B Did not meet co-primary endpoints of EFS/OS

Note: Regimen A is a standard 17-week regimen consisting of induction and continuation.

Induction

Chemotherapy, VDC portion (cycles 1, 3, 5)

  • Vincristine (Oncovin) by the following age- and weight-based criteria:
    • 10 kg or more AND 12 months old or older: 1.5 mg/m2 (maximum dose of 2 mg) IV push once per day on days 1 & 8
    • Less than 10 kg OR younger than 12 months old: 0.05 mg/kg IV push once per day on days 1 & 8
  • Doxorubicin (Adriamycin) by the following age- and weight-based criteria:
    • 10 kg or more AND 12 months old or older: 37.5 mg/m2 IV push/infusion over 1 to 15 minutes once per day on days 1 & 2
    • Less than 10 kg OR younger than 12 months old: 1.25 mg/kg IV push/infusion over 1 to 15 minutes once per day on days 1 & 2
      • Administer at a concentration not to exceed 2 mg/mL. Doxorubicin should be administered through the tubing of rapidly infusing solution of D5W or 0.9% NaCl, and it should not be infused into a large vein
  • Cyclophosphamide (Cytoxan) by the following age- and weight-based criteria:
    • 10 kg or more AND 12 months old or older: 1200 mg/m2 IV over 30 to 60 minutes once on day 1
    • Less than 10 kg OR younger than 12 months old: 40 mg/kg IV over 30 to 60 minutes once on day 1
      • May be administered as undiluted drug (20 mg/mL, reconstitute with 0.9% NaCl to avoid hypotonic solution) or further diluted

Supportive therapy, VDC portion (cycles 1, 3, 5)

  • Mesna (Mesnex) by the following age- and weight-based criteria:
    • 10 kg or more AND 12 months old or older: 720 mg/m2 IV infusion or IV/PO with cyclophosphamide once on day 1
    • Less than 10 kg OR younger than 12 months old: 24 mg/kg IV infusion or IV/PO with cyclophosphamide once on day 1

Chemotherapy, IE portion (cycles 2, 4, 6)

  • Ifosfamide (Ifex) by the following age- and weight-based criteria:
    • 10 kg or more AND 12 months old or older: 1800 mg/m2 IV over 60 minutes once per day on days 1 to 5
    • Less than 10 kg OR younger than 12 months old: 60 mg/kg IV over 60 minutes once per day on days 1 to 5
      • Achieve urine specific gravity less than or equal to 1.010 before starting ifosfamide.
  • Etoposide (Vepesid) by the following age- and weight-based criteria:
    • 10 kg or more AND 12 months old or older: 100 mg/m2 IV over 1 to 2 hours once per day on days 1 to 5
    • Less than 10 kg OR younger than 12 months old: 3.3 mg/kg IV over 1 to 2 hours once per day on days 1 to 5

Supportive therapy, IE portion (cycles 2, 4, 6)

  • Mesna (Mesnex) by the following age- and weight-based criteria:
    • 10 kg or more AND 12 months old or older: 1080 mg/m2 IV infusion or IV/PO with ifosfamide once per day on days 1 to 5
    • Less than 10 kg OR younger than 12 months old: 36 mg/kg IV infusion or IV/PO with ifosfamide once per day on days 1 to 5

14-day cycle for 6 cycles, followed by continuation (to be completed):

References

  1. COG AEWS1031: Leavey PJ, Laack NN, Krailo MD, Buxton A, Randall RL, DuBois SG, Reed DR, Grier HE, Hawkins DS, Pawel B, Nadel H, Womer RB, Letson GD, Bernstein M, Brown K, Maciej A, Chuba P, Ahmed AA, Indelicato DJ, Wang D, Marina N, Gorlick R, Janeway KA, Mascarenhas L. Phase III Trial Adding Vincristine-Topotecan-Cyclophosphamide to the Initial Treatment of Patients With Nonmetastatic Ewing Sarcoma: A Children's Oncology Group Report. J Clin Oncol. 2021 Dec 20;39(36):4029-4038. Epub 2021 Oct 15. Erratum in: J Clin Oncol. 2022 Jul 20;40(21):2393. link to original article link to PMC article PubMed NCT01231906
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