The following article features coverage from the Connective Tissue Oncology Society 2021 virtual meeting. Click here to read more of Cancer Therapy Advisor’s conference coverage.

Combination bevacizumab, sorafenib, and cyclophosphamide may be a beneficial palliative regimen for children and young adults with recurrent or refractory solid tumors, according to researchers.

“The antiangiogenic regimen was well tolerated, with minimal need for supportive care, and numerous patients experienced prolonged periods of disease stabilization,” said Jessica Bodea, MD, of St Jude Children’s Research Hospital in Memphis, Tennessee.

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Dr Bodea presented these results at the Connective Tissue Oncology Society (CTOS) 2021 Annual Meeting.

For this study, Dr Bodea and Sara M. Federico, MD, also of St Jude, retrospectively analyzed data from 39 patients with recurrent or refractory solid tumors. The patients had received the recommended phase 2 dose of bevacizumab, sorafenib, and low-dose cyclophosphamide.

Patients had Ewing sarcoma (36%), osteosarcoma (18%), rhabdoid tumor (7%), synovial sarcoma (7%), rhabdomyosarcoma (5%), hepatocellular carcinoma (5%), Wilms tumor (5%), high-grade sarcoma (5%), desmoplastic small round cell tumors (5%), clear cell meningioma (3%), and neuroblastoma (3%).

At baseline, the patients’ median age was 15 years (range, 1-22 years), 44% were female, and 71% had lung disease. The median number of prior systemic therapies was 3 (range, 0-6), and 73.7% of patients had received prior radiotherapy.

Efficacy and Safety

The overall response rate (ORR) was 7.7%, with 1 patient (2.6%) achieving a complete response and 2 (5.1%) achieving a partial response. Stable disease was seen in 51.3% of patients (n=20).

Among patients with bone sarcomas (n=21), the ORR was 9.5%, with 1 complete response (4.7%) and 1 partial response (4.7%). Stable disease was seen in 66.7% of patients (n=14). The median time to progression was 6 cycles (range, 2-46 cycles).

In all, 297 courses of therapy were administered, and 8 hospitalizations occurred as a result. A dose reduction of any agent was required in 63.9% of patients, most commonly due to hand/food exanthem (n=13) or myelosuppression (n=7).

The most common grade 3 or higher adverse events were hematologic in nature. These included lymphopenia (51%), leucopenia (35%), neutropenia (19%), and thrombocytopenia (16%).

“This regimen may be beneficial as a well-tolerated palliative option in solid tumors,” Dr Bodea said. “However, the demonstrated signal of activity in bone tumors suggests possible benefit for incorporation into upfront or maintenance therapy.”

Disclosures: Disclosures were not reported.

Read more of Cancer Therapy Advisor’s coverage of CTOS 2021 by visiting the conference page.


Bodea JL, Federico SM. The therapeutic regimen including bevacizumab, sorafenib and cyclophosphamide provides clinical benefit for the treatment of children and young adults with recurrent or refractory osseous sarcomas. Presented at CTOS 2021; November 10-13, 2021. Abstract P095.