Difference between revisions of "Ewing sarcoma, pediatric - historical"

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the [http://www.nccn.org/professionals/physician_gls/f_guidelines.asp NCCN Guidelines]. Is there a regimen missing from this list? See the [[Ewing Sarcoma, pediatric|main Ewing Sarcoma, pediatric page]] for current regimens.
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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the [http://www.nccn.org/professionals/physician_gls/f_guidelines.asp NCCN Guidelines]. Is there a regimen missing from this list? See the [[Ewing sarcoma, pediatric|main pediatric Ewing sarcoma page]] for current regimens.
  
 
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====References====
 
====References====
 
#'''COG AEWS0031:''' Womer RB, West DC, Krailo MD, Dickman PS, Pawel BR, Grier HE, Marcus K, Sailer S, Healey JH, Dormans JP, and Weiss AR. Randomized Controlled Trial of Interval-Compressed Chemotherapy for the Treatment of Localized Ewing Sarcoma: A Report From the Children's Oncology Group. J Clin Oncol. 2012 Nov 20;30(33):4148-4154. [https://dx.doi.org/10.1200%2FJCO.2011.41.5703 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494838/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/23091096/ PubMed] NCT00006734
 
#'''COG AEWS0031:''' Womer RB, West DC, Krailo MD, Dickman PS, Pawel BR, Grier HE, Marcus K, Sailer S, Healey JH, Dormans JP, and Weiss AR. Randomized Controlled Trial of Interval-Compressed Chemotherapy for the Treatment of Localized Ewing Sarcoma: A Report From the Children's Oncology Group. J Clin Oncol. 2012 Nov 20;30(33):4148-4154. [https://dx.doi.org/10.1200%2FJCO.2011.41.5703 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494838/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/23091096/ PubMed] NCT00006734
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[[Category:Ewing sarcoma regimens]]
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[[Category:Historical regimens]]
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[[Category:Disease-specific pages]]
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[[Category:Bone sarcomas]]
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[[Category:Pediatric solid tumors]]
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[[Category:Bone sarcomas]]
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[[Category:Pediatric solid tumors]]

Revision as of 10:39, 9 August 2022

Back to Top

The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main pediatric Ewing sarcoma page for current regimens.

0 regimens on this page
0 variants on this page


Historical Regimens

COG AEWS0031

Regimen A Induction

  • Regimen A is a standard regimen consisting of 21 day cycles

Cycles 1 & 3 (VDC)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Doxorubicin (Adriamycin) 75 mg/m2 IV infusion over 48 hours once on day 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

21 day cycle

Cycles 2 & 4 (IE)

  • Ifosfamide (Ifex) 1800 mg/m2 IV infusion over 1 hour once on day 1 to 5
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Etoposide (Vepesid) 100 mg/m2 IV infusion over 1 to 2 hours once on days 1 to 5
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 1080 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 6
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

21 day cycle

Regimen A Continuation

  • At week 13 patients either underwent surgery, received radiation, or both
  • Radiation coincided with cycle 5

Cycle 5 & 9 (VDC)

Cycle 5 begins on week 15 in patients receiving surgery and on week 13 in Regimen A2
  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Doxorubicin (Adriamycin) 75 mg/m2 IV infusion over 48 hours once on day 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

21 day cycle

Cycle 6, 8, 10, 12, & 14 (IE)

  • Ifosfamide (Ifex) 1800 mg/m2 IV infusion over 1 hour once on day 1 to 5
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Etoposide (Vepesid) 100 mg/m2 IV infusion over 1 to 2 hours once on days 1 to 5
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 1080 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 6
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

21 day cycle

Cycle 7 (VDC) Regimen A1 (Surgery Only)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Doxorubicin (Adriamycin) 75 mg/m2 IV infusion over 48 hours once on day 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

21 day cycle

Cycle 7 (VC) Regimen A2 & A3 (Radiation w/ or w/o Surgery)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

21 day cycle

Cycle 11 (VC) Regimen A1 (Surgery Only)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

21 day cycle

Cycle 11 (VDC) Regimen A2 & A3 (Radiation w/ or w/o Surgery)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Doxorubicin (Adriamycin) 75 mg/m2 IV infusion over 48 hours once on day 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

21 day cycle

Cycle 13 (VC)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

21 day cycle

Regimen B Induction

  • Regimen B is a consolidated regimen consisting of 14 day cycles

Cycles 1, 3, & 5 (VDC)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Doxorubicin (Adriamycin) 75 mg/m2 IV infusion over 48 hours once on day 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

14 day cycle

Cycle 2, 4, & 6 (IE)

  • Ifosfamide (Ifex) 1800 mg/m2 IV infusion over 1 hour once on day 1 to 5
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Etoposide (Vepesid) 100 mg/m2 IV infusion over 1 to 2 hours once on days 1 to 5
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 1080 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 6
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

14 day cycle

Regimen B Continuation

  • At week 13 patients either underwent surgery, received radiation, or both
  • Radiation coincided with cycle 7

Cycle 7 (VDC)

Cycle 7 begins on week 15 in patients receiving surgery and on week 13 in Regimen B2
  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Doxorubicin (Adriamycin) 75 mg/m2 IV infusion over 48 hours once on day 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

14 day cycle


Cycle 8, 10, 12, & 14 (IE)

  • Ifosfamide (Ifex) 1800 mg/m2 IV infusion over 1 hour once on day 1 to 5
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Etoposide (Vepesid) 100 mg/m2 IV infusion over 1 to 2 hours once on days 1 to 5
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 1080 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 6
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

14 day cycle

Cycle 9 (VDC) Regimen B1 (Surgery Only)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Doxorubicin (Adriamycin) 75 mg/m2 IV infusion over 48 hours once on day 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

14 day cycle

Cycle 9 (VC) Regimen B2 & B3 (Radiation w/ or w/o Surgery)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

14 day cycle

Cycle 11 (VC)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

14 day cycle

Cycle 13 (VC) Regimen B1 (Surgery Only)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

14 day cycle

Cycle 13 (VDC) Regimen B2 & B3 (Radiation w/ or w/o Surgery)

  • Vincristine (Oncovin) 2 mg/m2 IV push once on day 1 (maximum dose of 2 mg)
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Doxorubicin (Adriamycin) 75 mg/m2 IV infusion over 48 hours once on day 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Cyclophosphamide (Cytoxan) 1200 mg/m2 IV over 1 hour on Days 1
    • Treat with 50% doses calculated on a m2 basis for children < 1 year, then consider increasing to 75% and then to 100 % of calculated dose if tolerated
  • Mesna (Mesnex) 720 mg/m2 IV continuous infusion on day 1
  • Filgrastim (Neupogen) 5 mcg/kg SC for at least 7 days, or until ANC ≥ 750/μl, beginning on day 2
    • ANC ≥ 750/μl on or before day 7 of the cycle is not sufficient for discontinuing G-CSF

14 day cycle

References

  1. COG AEWS0031: Womer RB, West DC, Krailo MD, Dickman PS, Pawel BR, Grier HE, Marcus K, Sailer S, Healey JH, Dormans JP, and Weiss AR. Randomized Controlled Trial of Interval-Compressed Chemotherapy for the Treatment of Localized Ewing Sarcoma: A Report From the Children's Oncology Group. J Clin Oncol. 2012 Nov 20;30(33):4148-4154. link to original article link to PMC article PubMed NCT00006734
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