A trial looking at treatment for the Ewing sarcoma family of tumours (Euro Ewing 2012)
Cancer type:
Status:
Phase:
This trial compared different combinations of chemotherapy for the Ewing sarcoma family of tumours. These are cancers which start in the bones or the soft tissue around the bones.
The trial was supported by Cancer Research UK. It was open for children and adults to join between 2014 and 2019. The team published initial results in 2022.
More about this trial
Doctors usually treat the with chemotherapy. When this trial was done, treatment options included 2 main combinations of drugs.
Doctors in Europe often used vincristine, ifosfamide, doxorubicin and etoposide (VIDE) followed by either:
- vincristine, actinomycin D, and ifosfamide (VAI) or
- vincristine, actinomycin D and cyclophosphamide (VAC)
Doctors in America often used vincristine, doxorubicin, cyclophosphamide, ifosfamide and etoposide (VDC/IE) followed by:
- ifosfamide and etoposide (IE) and then
- vincristine and cyclophosphamide (VC)
There is information about all of these treatments in our Cancer drugs section.
Sometimes people have chemotherapy before surgery. This is to make the cancer smaller and easier to remove. Some people also have chemotherapy or radiotherapy after their operation. This is to help stop the cancer coming back.
The main aims of this trial were to:
- compare VIDE and VDC/IE to see which is best
- see if having an extra drug called zoledronic acid is better or not
Summary of results
The research team found that VDC/IE worked better for Ewing sarcoma than VIDE.
VDC/IE is vincristine, doxorubicin, cyclophosphamide, ifosfamide and etoposide.
VIDE is vincristine, ifosfamide, doxorubicin and etoposide.
Trial design
This trial was for children and adults up to 50 years old who had a .
The people taking part were put into 1 of 2 treatments groups at random. One group had VIDE treatment. The other group had VDC/IE treatment.
After that, they had an operation to remove the sarcoma. Some people also had radiotherapy or more chemotherapy. The treatment they had depended on how well the first course of treatment had worked.
Some people also had a drug called zoledronic acid as part of this trial, and some didn’t. Who had this drug was decided at random. We plan to add the results for this part of the trial when they are available.
Results
A total of 640 people from 10 different countries joined this trial. There were:
- 320 people in the VIDE group
- 320 people in the VDC/IE group
The research team looked at how many people’s cancer had not come back or got worse in the 3 years after joining the trial. They found it was:
- just over than 6 out of 10 people (61%) of those who had VIDE
- just under 7 out of 10 people (67%) of those who had VDC/IE
They also looked at how many people were living 3 years after joining the trial. They and found it was:
- more than 7 out of 10 people (74%) of those who had VIDE
- more than 8 out of 10 people (82%) of those who had VDC/IE
Side effects
Most people taking part had at least 1 side effect from treatment. Some were mild or didn’t last long. But many people had at least 1 side effect that was more severe.
The most common of the more severe side effects for both treatment groups were:
- a drop in white blood cells and high temperature (febrile neutropenia)
- a drop in red blood cells (anaemia)
- sore mouth (mucositis)
- tummy (abdominal) pain
- feeling sick
- constipation
More people in the VIDE group had a drop in white blood cells and a temperature. The other side effects affected a similar number of people in both groups.
There is information about the side effects of all the drugs used in this trial in our Cancer drugs section.
Conclusion
The research team concluded that VDC/IE treatment was better than VIDE for Ewing sarcoma. They also found that it didn’t cause any more side effects than VIDE.
They suggest that VDC/IE is used as a standard treatment for Ewing sarcoma.
More detailed information
There is more information about this research in the reference below.
Please note, the article in the link below is not in plain English. It has been written for healthcare professionals and researchers.
Comparison of two chemotherapy regimens in patients with newly diagnosed Ewing sarcoma (EE2012): an open-label, randomised, phase 3 trial
B Brennan and others
The Lancet, 2022. Volume 400, issue 10362, pages 1513 – 1521.
Where this information comes from
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists () but may not have been published in a medical journal. The figures we quote above were provided by the research team. We have not analysed the data ourselves.
Recruitment start:
Recruitment end:
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Chief Investigator
Professor Bernadette Brennan
Supported by
Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer
University of Birmingham
Other information
This is Cancer Research UK number CRUK/11/050.
If you have questions about the trial please contact our cancer information nurses
Freephone 0808 800 4040