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Prioritization of Novel Agents for Patients with Rhabdomyosarcoma: A Report from the Children's Oncology Group (COG)
Holly L Pacenta1,2, Wendy Allen-Rhoades3, David Langenau4
1Cook Children's Medical Center, Division of Hematology and Oncology, Fort Worth, TX 76014, USA.
Abstract:
Rhabdomyosarcoma is the most common soft tissue sarcoma diagnosed in children and adolescents. Patients that are diagnosed with advanced or relapsed disease have exceptionally poor outcomes. The Children's Oncology Group (COG) convened a rhabdomyosarcoma new agent task force in 2020 to systematically evaluate novel agents for inclusion in phase 2 or phase 3 clinical trials for patients diagnosed with rhabdomyosarcoma, following a similar effort for Ewing sarcoma. The task force was comprised of clinicians and basic scientists who collectively identified new agents for evaluation and prioritization in clinical trial testing. Here, we report the work of the task force including the framework upon which the decisions were rendered and review the top classes of agents that were discussed. Representative agents include poly-ADP-ribose polymerase (PARP) inhibitors in combination with cytotoxic agents, mitogen-activated protein kinase (MEK) inhibitors in combination with type 1 insulin-like growth factor receptor (IGFR1) inhibitors, histone deacetylase (HDAC) inhibitors, and novel cytotoxic agents.
Insights
Children
Area of Science:
- Pediatric Oncology
- Medical Oncology
- Drug Discovery
Background:
- Rhabdomyosarcoma is a prevalent soft tissue sarcoma in children and adolescents.
- Advanced or relapsed rhabdomyosarcoma presents significant treatment challenges with poor patient outcomes.
Purpose of the Study:
- To systematically evaluate novel therapeutic agents for rhabdomyosarcoma.
- To prioritize agents for inclusion in future clinical trials (Phase 2/3) for pediatric rhabdomyosarcoma patients.
Main Methods:
- Convened a multidisciplinary task force (clinicians and scientists) under the Children's Oncology Group (COG).
- Developed a framework for evaluating and prioritizing novel agents.
- Reviewed key classes of investigational drugs for rhabdomyosarcoma treatment.
Main Results:
- Identified and reviewed promising novel agents for rhabdomyosarcoma.
- Key agent classes discussed include PARP inhibitors, MEK inhibitors, HDAC inhibitors, and novel cytotoxic agents.
- Prioritized agents for further clinical investigation based on the established framework.
Conclusions:
- The COG rhabdomyosarcoma new agent task force established a systematic approach for novel drug evaluation.
- Several classes of novel agents show promise for improving outcomes in pediatric rhabdomyosarcoma.
- This work will guide the development of future clinical trials for rhabdomyosarcoma.
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