Metastatic Ewing's Trial Testing Schedule Enhancement to Improve Outcomes
Summary
This single arm study is designed to demonstrate the feasibility of a radically different approach for an exceptionally high-risk subset of MES with widely metastatic disease (WMES). We incorporate the use of evolutionary principles that apply to species and population dynamics as related to adaptation and extinction to populations of cancer cells that similarly adapt and that we are attempting to make extinct, resulting in a cure for the patient. Such principles include an initial intense first strike to deplete the bulk of the cancer cells, followed by a series of sequential second strikes towards eliminating residual, resistant populations, followed by a prolonged period of maintenance chemotherapy to eliminate any remnant cells, using agents generally regarded to be active against newly diagnosed ES.
Arms & interventions
- DrugVincristine
IV Push
- DrugDoxorubicin
IV
- DrugCyclophosphamide
IV and Maintenance PO
- DrugIfosfamide
IV
- DrugActinomycin
IV
- DrugIrinotecan
IV
- DrugCabozantinib
PO
- DrugTopotecan
IV
- DrugTemozolomide
IV
- DrugEtoposide
PO
- DrugLiposomal doxorubicin
IV
Outcome measures
Primary
Feasibility and Safety - Consolidation
The treatment will be considered feasible if 70% of Ewing sarcoma patients make it through consolidation.
Time frame: 16 months
Feasibility and Safety - Maintenance
The treatment will be considered feasible if 50% of Ewing sarcoma patients make it through 6 cycles of maintenance.
Time frame: 16 months
Secondary
Event-Free Survival
Time frame: 3 years
Off Treatment Event Free Survival
Time frame: 3 years
Overall Survival
Time frame: 3 years
Eligibility criteria
Study locations (17)
University of Alabama at Birmingham (Children's of Alabama)
Birmingham, Alabama, 35233
Phoenix Children's Hospital
Phoenix, Arizona, 85016
Connecticut Children's Medical Center
Hartford, Connecticut, 06106
University of Florida
Gainesville, Florida, 32610
Nemours Jacksonville
Jacksonville, Florida, 32207
University of Miami
Miami, Florida, 33136
Moffitt Cancer Center
Tampa, Florida, 33612
University of Kentucky
Lexington, Kentucky, 40536
Helen DeVos Children's Hospital
Grand Rapids, Michigan, 49503
Roswell Park Comprehensive Cancer Center
Buffalo, New York, 14263
Montefiore Medical Center
The Bronx, New York, 10467
University of North Carolina
Chapel Hill, North Carolina, 27599
Levine Cancer Institute
Charlotte, North Carolina, 28204
Cleveland Clinic Children's
Cleveland, Ohio, 44195
Nationwide Children's Hospital
Columbus, Ohio, 43205
Vanderbilt University Medical Center
Nashville, Tennessee, 37232
Primary Children's Hospital
Salt Lake City, Utah, 84113