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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
IV Push
IV
IV and Maintenance PO
IV
IV
IV
PO
IV
IV
PO
IV
University of Alabama at Birmingham (Children's of Alabama)
Birmingham, Alabama, United States
RECRUITINGPhoenix Children's Hospital
Phoenix, Arizona, United States
NOT_YET_RECRUITINGConnecticut Children's Medical Center
Hartford, Connecticut, United States
NOT_YET_RECRUITINGUniversity of Florida
Gainesville, Florida, United States
RECRUITINGNemours Jacksonville
Jacksonville, Florida, United States
NOT_YET_RECRUITINGUniversity of Miami
Miami, Florida, United States
RECRUITINGMoffitt Cancer Center
Tampa, Florida, United States
RECRUITINGUniversity of Kentucky
Lexington, Kentucky, United States
NOT_YET_RECRUITINGHelen DeVos Children's Hospital
Grand Rapids, Michigan, United States
NOT_YET_RECRUITINGRoswell Park Comprehensive Cancer Center
Buffalo, New York, United States
NOT_YET_RECRUITING...and 7 more locations
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
Event-Free Survival
EFS is defined as time from treatment initiation to event which includes (1) recurrence, (2) secondary malignancy, and (3) death due to any cause.
Time frame: 3 years
Off Treatment Event Free Survival
otEFS is defined as time from treatment initiation to event 66 which includes (1) any recurrence (local or regional, or distant) that leads to coming off protocol therapy and (2) death due to any cause.
Time frame: 3 years
Overall Survival
The time to event endpoint of overall survival is defined as the duration of time from diagnosis to death or last follow-up timepoint, where event would be death from any cause.
Time frame: 3 years
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