AEWS0031: randomised trial of interval-compressed chemotherapy for localised Ewing sarcoma
Giving the standard Ewing sarcoma chemotherapy every two weeks rather than every three cured more patients, 73 against 65 percent free of events at five years, with no more side effects.
Overview
Children's Oncology Group phase 3 trial: 587 patients with localised Ewing sarcoma (568 eligible, 284 per arm) were randomised to alternating vincristine-doxorubicin-cyclophosphamide and ifosfamide-etoposide every 21 days or every 14 days with filgrastim.
The median cycle interval achieved was 21 days (standard) and 15 days (intensified). Event-free survival at a median of five years was 65 percent in the standard arm and 73 percent in the intensified arm (p 0.048); toxicity was similar.
- Five-year event-free survival 73 percent with interval-compressed chemotherapy versus 65 percent with standard timing (p 0.048).
- Median cycle interval 15 versus 21 days; toxicity similar.
Interval-compressed VDC/IE is the standard first-line chemotherapy for localised Ewing sarcoma in North America; Euro Ewing 2012 later adopted it in Europe.
- Localised disease only; the benefit in metastatic disease was not tested here.
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