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Pediatric Patients with Stage IV Rhabdomyosarcoma Significantly Benefit from Long-Term Maintenance Therapy : Results of the CWS-IV 2002 and the CWS DOK IV 2004-Trials
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- Tramsen, Lars (author)
- Univ Hosp Schleswig Holstein, Dept Pediat, Campus Kiel, D-24105 Kiel, Germany.;Goethe Univ, Univ Hosp, Dept Children & Adolescents, D-60590 Frankfurt, Germany.
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- Bochennek, Konrad (author)
- Goethe Univ, Univ Hosp, Dept Children & Adolescents, D-60590 Frankfurt, Germany.
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- Sparber-Sauer, Monika (author)
- Olgahosp Stuttgart Canc Ctr, Hosp State Capital Stuttgart, Ctr Pediat Adolescent & Womens Med, Pediat Oncol Hematol Immunology 5, D-70174 Stuttgart, Germany.;Univ Tubingen, Fac Med, D-72016 Tubingen, Germany.
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- Salzmann-Manrique, Emilia (author)
- Goethe Univ, Univ Hosp, Dept Children & Adolescents, D-60590 Frankfurt, Germany.
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- Scheer, Monika (author)
- Charite Univ Med Berlin, Dept Pediat Oncol & Hematol, Augustenburger Pl 1, D-13353 Berlin, Germany.
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- Dantonello, Tobias (author)
- Univ Bern, Bern Univ Hosp, Dept Pediat, Div Pediat Hematol & Oncol, CH-3010 Bern, Switzerland.
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- Borkhardt, Arndt (author)
- Heinrich Heine Univ, Med Fac, Dept Pediat Oncol Hematol & Clin Immunol, D-40225 Dusseldorf, Germany.
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- Dirksen, Uta (author)
- Univ Hosp Essen, West German Canc Ctr, Pediat 3, D-45147 Essen, Germany.;Natl Ctr Tumor Dis NCT Site Essen, German Canc Consortium Site Essen, D-45147 Essen, Germany.
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- Thorwarth, Anne (author)
- Charite Univ Med Berlin, Dept Pediat Oncol & Hematol, Augustenburger Pl 1, D-13353 Berlin, Germany.
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- Greiner, Jeanette (author)
- Kantonsspital Aarau AG, Childrens Hosp, Pediat Oncol & Hematol, CH-5001 Aarau, Switzerland.
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- Ebinger, Martin (author)
- Univ Childrens Hosp, Dept Gen Pediat & Pediat Oncol & Hematol, D-72076 Tubingen, Germany.
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- Weclawek-Tompol, Jadwiga (author)
- Univ Med Wroclaw, Dept Bone Marrow Transplantat, Pediat Oncol & Haematol, Wroclaw, Poland.
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- Ladenstein, Ruth (author)
- St Anna Childrens Hosp, Childrens Canc Res Inst CCRI, A-1090 Vienna, Austria.
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- Ljungman, Gustaf, 1958- (author)
- Uppsala universitet,Barnonkologisk forskning - särskilt fokus på komplikationer,Uppsala Univ, Dept Womens & Childrens Hlth, Pediat Oncol, S-75185 Uppsala, Sweden.
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- Hallmen, Erika (author)
- Olgahosp Stuttgart Canc Ctr, Hosp State Capital Stuttgart, Ctr Pediat Adolescent & Womens Med, Pediat Oncol Hematol Immunology 5, D-70174 Stuttgart, Germany.
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- Lehrnbecher, Thomas (author)
- Goethe Univ, Univ Hosp, Dept Children & Adolescents, D-60590 Frankfurt, Germany.
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- Koscielniak, Ewa (author)
- Olgahosp Stuttgart Canc Ctr, Hosp State Capital Stuttgart, Ctr Pediat Adolescent & Womens Med, Pediat Oncol Hematol Immunology 5, D-70174 Stuttgart, Germany.;Univ Tubingen, Fac Med, D-72016 Tubingen, Germany.
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- Klingebiel, Thomas (author)
- Goethe Univ, Univ Hosp, Dept Children & Adolescents, D-60590 Frankfurt, Germany.
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Univ Hosp Schleswig Holstein, Dept Pediat, Campus Kiel, D-24105 Kiel, Germany;Goethe Univ, Univ Hosp, Dept Children & Adolescents, D-60590 Frankfurt, Germany. Goethe Univ, Univ Hosp, Dept Children & Adolescents, D-60590 Frankfurt, Germany. (creator_code:org_t)
- 2023-03-30
- 2023
- English.
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In: Cancers. - : MDPI. - 2072-6694. ; 15:7
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Abstract
Subject headings
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- Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma (STS) in childhood. Whereas more than 90% of patients with localized low-risk RMS can be cured, metastatic RMS have a dismal outcome, with survival rates of less than 30%. The HD CWS-96 trial showed an improved outcome for patients receiving maintenance therapy after completing intensive chemotherapy. Consequently, the international clinical trials CWS-IV 2002 and CWS DOK IV 2004 on metastatic disease of STS of the Cooperative Weichteilsarkom Studiengruppe (CWS) were designed in addition to the CWS-2002P trial for localized RMS disease. All patients received a multimodal intensive treatment regimen. To maintain remission, three options were compared: long-term maintenance therapy (LTMT) versus allogeneic hematopoietic stem cell transplantation (alloHSCT) versus high-dose chemotherapy (HDCT). A total of 176 pediatric patients with a histologically confirmed diagnosis of metastatic RMS or RMS-like tumor were included. A total of 89 patients receiving LTML showed a significantly better outcome, with an event-free survival (EFS) of 41% and an overall survival (OS) of 53%, than alloHSCT (n = 21, EFS 19%, p = 0.02, OS 24%, p = 0.002). The outcome of LTML was slightly improved compared to HDCT (n = 13, EFS 35%, OS 34%). In conclusion, our data suggest that in patients suffering from metastatic RMS, long-term maintenance therapy is a superior strategy in terms of EFS and OS compared to alloHSCT. EFS and OS of HDCT are similar in these strategies; however, the therapeutic burden of LTMT is much lower.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- soft tissue sarcoma
- rhabdomyosarcoma
- metastatic
- children
- long-term maintenance therapy
- outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
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Tramsen, Lars
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Bochennek, Konra ...
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Sparber-Sauer, M ...
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Salzmann-Manriqu ...
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Scheer, Monika
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Dantonello, Tobi ...
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Borkhardt, Arndt
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Dirksen, Uta
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Thorwarth, Anne
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Greiner, Jeanett ...
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Ebinger, Martin
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Weclawek-Tompol, ...
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Ladenstein, Ruth
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Ljungman, Gustaf ...
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Hallmen, Erika
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Lehrnbecher, Tho ...
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Koscielniak, Ewa
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Klingebiel, Thom ...
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Cancers
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Uppsala University