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Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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In Vivo Model for Testing Effect of Hypoxia on Tumor Metastasis
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[Chemotherapy in patients with refractory Ewing sarcoma].

Anna Raciborska1, Katarzyna Bilska, Katarzyna Drabko

  • 1Klinika Chirurgii Onkologicznej Dzieci i Młodzieży, Instytut Matki i Dziecka w Warszawie, Warszawa. anna.raciborska@hoga.pl

Medycyna Wieku Rozwojowego
|August 31, 2013
PubMed
Summary

The VIT regimen (vincristine, irinotecan, temozolomide) shows comparable effectiveness to the PACE regimen for refractory Ewing sarcoma, with significantly lower toxicity. This makes VIT a valuable option for treating this rare pediatric cancer.

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Area of Science:

  • Pediatric Oncology
  • Medical Chemotherapy
  • Sarcoma Research

Background:

  • Ewing sarcoma is a rare bone cancer with poor prognosis in recurrent or metastatic stages.
  • Salvage chemotherapy regimens are crucial for managing refractory cases.

Purpose of the Study:

  • To compare the efficacy and toxicity of two salvage chemotherapy regimens in patients with refractory Ewing sarcoma.
  • To evaluate the outcomes of the vincristine, irinotecan, and temozolomide (VIT) regimen versus the cisplatin, doxorubicin, cyclophosphamide, and teniposide (PACE) regimen.

Main Methods:

  • A cohort study comparing VIT (n=22) and PACE (n=20) regimens in pediatric patients with refractory Ewing sarcoma (2008-2012).
  • Outcomes assessed included overall response rate, time to progression, and survival using Kaplan-Meier analysis.
  • Toxicity profiles were documented and compared between the two regimens.

Main Results:

  • Overall response rates were 68.1% for VIT and 75% for PACE.
  • Median time to progression was 3.0 months for VIT and 3.5 months for PACE.
  • Two-year overall survival after recurrence was 29.94% with no significant difference between groups, but PACE exhibited significantly higher toxicity.

Conclusions:

  • The VIT regimen is an effective alternative to conventional chemotherapy for refractory Ewing sarcoma.
  • VIT demonstrates a more favorable toxicity profile compared to the PACE regimen, suggesting it as a preferred option.