VDC/ICE Protocol May Be Feasible, Effective for Ewing Sarcoma

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The VDC/ICE protocol was feasible and resulted in comparable results to those reported by cooperative groups in high-income countries in patients with Ewing sarcoma with high tumor burden, a study published in the journal Pediatric Blood and Cancer has shown.

For the study, researchers enrolled 175 patients less than 30 years of age with Ewing sarcoma, 39% of which had metastatic disease.

Of the total population, 52 patients were low-risk and 123 were high-risk. All patients received induction chemotherapy consisting of two cycles of ICE (ifosfamide, carboplatin, and etoposide) followed by two cycles of VDC (vincristine, doxorubicin, and cyclophosphamide), followed by local control.

Low-risk patients then received 10 additional alternating cycles of IE with VDC while those with low-risk disease received two additional courses of ICE.

Results showed that overall response rate after induction was 27.4%. Estimated overall survival was 54.4% and estimated 5-year event-free survival was 51.4%.

Researchers found that patients with localized disease experienced better outcomes than those with metastatic disease, and metastatic disease was the only prognostic factor identified (P < 0.01).

Androgen receptor V7 (AR-V7) status does not predict response to taxane chemotherapy in metastatic c
The VDC/ICE protocol was feasible in patients with Ewing sarcoma with high tumor burden.
Large cooperative group studies have shown the efficacy of risk-adapted treatment for Ewing sarcoma. However, validation and local adaptation by National cooperative groups is needed.
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