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- Title
Risk-based treatment for patients with first relapse or progression of rhabdomyosarcoma: A report from the Children's Oncology Group.
- Authors
Mascarenhas, Leo; Lyden, Elizabeth R.; Breitfeld, Philip P.; Walterhouse, David O.; Donaldson, Sarah S.; Rodeberg, David A.; Parham, David M.; Anderson, James R.; Meyer, William H.; Hawkins, Douglas S.
- Abstract
<bold>Background: </bold>The purpose of this study was to evaluate risk and response-based multi-agent therapy for patients with rhabdomyosarcoma (RMS) at first relapse.<bold>Methods: </bold>Patients with RMS and measurable disease at first relapse with unfavorable-risk (UR) features were randomized to a 6-week phase 2 window with 1 of 2 treatment schedules of irinotecan with vincristine (VI) (previously reported). Those with at least a partial response to VI continued to receive 44 weeks of multi-agent chemotherapy including the assigned VI regimen. UR patients who did not have measurable disease at study entry, did not have a radiographic response after the VI window, or declined VI window therapy received 31 weeks of multi-agent chemotherapy including tirapazamine (TPZ) at weeks 1, 4, 10, 19, and 28. Favorable-risk (FR) patients received 31 weeks of the same multi-agent chemotherapy without VI and TPZ.<bold>Results: </bold>One hundred thirty-six eligible patients were enrolled. For 61 patients not responding to VI, the 3-year failure-free survival (FFS) and overall survival (OS) rates were 17% (95% confidence interval [CI], 8%-29%) and 24% (13%-37%), respectively. For 30 UR patients not treated with VI, the 3-year FFS and OS rates were 21% (8%-37%) and 39% (20%-57%), respectively. FR patients had 3-year FFS and OS rates of 79% (47%-93%) and 84% (50%-96%), respectively. There were no unexpected toxicities.<bold>Conclusions: </bold>Patients with UR RMS at first relapse or disease progression have a poor prognosis when they are treated with this multi-agent therapy, whereas FR patients have a higher chance of being cured with second-line therapy.
- Subjects
THERAPEUTICS; DISEASE relapse; ONCOLOGY; DISEASE progression; RHABDOMYOSARCOMA; SURVIVAL analysis (Biometry)
- Publication
Cancer (0008543X), 2019, Vol 125, Issue 15, p2602
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.32122