SCMCIE94: an intensified pilot treatment protocol known to be associated with cure in CD 56-negative non-pelvic isolated Ewing sarcoma (EWS) is also associated with no early relapses in non-metastatic extremity EWS

Ian Joseph Cohen, Helen Toledano, Jerry Stein, Yehuda Kollender, Eyal Fenig, Osnat Konen, Zvi Bar-Sever, Josephine Issakov, Meora Feinmesser, Smadar Avigad, Shifra Ash

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Abstract

Purpose: We report the unexpected absence of early relapse (before 30 months) in 24 consecutive patients with isolated limb primary Ewing sarcoma treated with an intensified pilot protocol, SCMCIE94. Methods: Clinical data for the study were collected retrospectively from the patient files. The protocol included 6 courses of chemotherapy, split radiation, and limb salvage surgery. This SCMCIE94 protocol had been used in almost all the patients described in an earlier report, in whom those with non-pelvic isolated tumors and low/absent CD56 expression in Ewing sarcoma tumor cells were all long-term survivors. Results: The 5-year (10-year) event-free survival rate for the patients with isolated limb primary Ewing sarcoma was 78.95 ± 8.3% (68.6 ± 10.0%) and the overall survival rate was 90.7 ± 6.2% (71.1 ± 11.2%). There were no relapses before 30 months in any of these patients. Conclusion: The intensified SCMCIE94 pilot protocol has been shown previously to cure patients with localized CD56-negative non-pelvic Ewing sarcoma. The present study shows that among all patients with localized extremity disease who were treated with this protocol, there were no cases of early relapse. Although our cohort was small, the difference in results from studies using other protocols is so striking, that it would seem reasonable to assume it is attributable to the changes made in the protocol itself rather than risk factors. Late relapses of isolated limb CD56-positive Ewing sarcoma suggest minimal residual disease warranting additional therapeutic approaches such as autologous stem cell rescue after Busulfan Melfelan.

Original languageEnglish
Pages (from-to)859-866
Number of pages8
JournalCancer Chemotherapy and Pharmacology
Volume83
Issue number5
DOIs
StatePublished - 1 May 2019

Keywords

  • CD56
  • Early relapse prevention
  • Limb Ewing sarcoma
  • Non-metastatic
  • Non-pelvic
  • SCMCIE94
  • Treatment outcome

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