Katherine Janeway, MD

Invited discussant of the rEECur trial, Katherine Janeway, MD, of Harvard Medical School, said that her comments pertained to Ewing sarcoma as well as to all rare cancers, “which comprise about 25% of all cancers diagnosed.”

“Ewing sarcoma is quite rare, arising in the bone in about 75% of patients and in the soft tissue in 25%. Despite the driving event being identified 30 years ago, it has been difficult to develop therapy, and we rely on cytotoxic chemotherapy given intensively every 2 weeks. However, the outcome is relatively poor, especially in those with metastatic and recurrent disease. Prior to this trial, we had limited evidence to guide us,” she told listeners.

“This study was based on collaboration with 13 European countries as well as Australia and New Zealand. It takes several years to accrue patients with such a rare disease. Both treatment arms had better outcomes than historical results obtained in trials of ineffective therapies. These results will inform patient management and will help drug development for Ewing sarcoma. We will need to consider ifosfamide as one option for backbone chemotherapy for future trials,” Dr. Janeway said.

“These results are sobering, even with high-dose ifosfamide. Clearly, we need to do better and think about drug development for these rare diseases and fusion-driven sarcomas. I’m encouraged by ongoing trials of chemotherapy plus novel agents. We need such trials to show this approach is better than chemotherapy alone,” she stated. 

DISCLOSURE: Dr. Janeway has received honoraria from Foundation Medicine and Takeda; has served as a consultant or advisor to Bayer and Ipsen; and has been reimbursed for travel, accommodations, and expenses by Bayer.