A SECOND LINE REGIMEN FOR EWING SARCOMA

Pediatr Blood Cancer. 2009 Jul 27. [Epub ahead of print]

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Irinotecan and temozolomide for Ewing sarcoma: The Memorial Sloan-Kettering experience.

Casey DA, Wexler LH, Merchant MS, Chou AJ, Merola PR, Price AP, Meyers PA.

Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York.

BACKGROUND: The prognosis for recurrent/progressive Ewing sarcoma (ES) remains poor. Pre-clinical, adult phase I and II trials have demonstrated the combination of irinotecan and temozolomide to have schedule-dependent synergy and significant antitumor activity. A pediatric phase I trial has shown this regimen to be safe and active in advanced ES. PROCEDURE: We conducted a retrospective chart review to identify patients with recurrent/progressive ES treated with irinotecan [20 mg/m(2)/day x 5(x2)] and temozolomide (100 mg/m(2)/day x 5) in our institution. The best response achieved, time to progression (TTP), and associated toxicities were recorded. RESULTS: Twenty patients received a total of 154 cycles of therapy. Of 19 evaluable patients, there were 5 complete and 7 partial responses (a 63% overall objective response). Median TTP for 20 evaluable patients with recurrent/progressive ES was 8.3 months; for the subset of 14 patients with recurrent ES, it was 16.2 months. Median TTP was better for patients who sustained a 2-year first remission than for those who relapsed <24>