Trials Update May 2019 EuroEwings - PowerPoint Presentation

Slide1

Trials Update

May 2019

Slide2

Slide3

EuroEwings 2012

Slide4

EE 2012

Now closed,

R1

recruited over its target of 600

Webex

meetings ? Next week

Letter to investigators

VDC

/IE is superior to VIDE induction

Next first line

Ewings

trial still in development

Good UK recruitment

Biological samples – good, not great

Slide5

Local control audit

RT alone 22%

Surgery alone 28%

Both 50%

Slide6

RECCUR

Slide7

RECCUR

Relapsed

Ewings

Measurable disease, biological,

QoL

4 arms:

can elect not to use 1 for specific patient

Irinotecan

/

Temozolomide

Ifosfamide

Gemcitabine

/

Docetaxel

(poorer RR and

efs

)

Cyclophosphamide

/

Topotecan

Slide8

Quality of Life

SAM – Sarcoma Assessment Measure

EORTC

- in development

Slide9

SAM

Sarcoma Assessment Measure

Developing a

QoL

tool for Sarcoma

In phase II (1000 pts)

Hope that this will be available for use in trials

40 for Glasgow

Slide10

Rhabdomyosarcoma

Long running trials

Most participants are paediatric

Guide our adult practice

RMS 2005

EpSSG

etc

Slide11

FaR RMS

Children and young adults (? Up to 29)

Alveolar and

Embryonal

(based on fusion status)

All stages

PET CT at diagnosis

Very complicated

RT

section with randomisations

Slide12

FaR RMS

Very high risk:

IVADo

+/-

irinotecan

High Risk: IVA +/-

irinotecan

Maintenance: 6 v 12 v 24 months

Cyclo

/Vin

Risk group dependant

Relapse: VI v

VIT

or similar (?

Regorafanib

)

Slide13

Retroperitoneal Sarcoma

Interest in improving outcomes by adding something to surgery

Various papers, single institution publications

Conflicting outcomes

Previous American Study failed to recruit

Slide14

STRASS 1

Operable retroperitoneal sarcoma

RT

pre op or no radiotherapy

No safety concerns between the 2 arms

Still not reported, due at

ASCO

next month

Tried to open, too difficult to get through

RT

dept

Slide15

STRASS 2

In development, final protocol soon.

Chemotherapy question. PET CT, MRI, Biological

Neoadj

chemo x 3 for operable

High grade

Leiomyosarcoma

(

DTIC

/

adria

)

High grade and De diff

Liposarcoma

(

ifos

/

adria

)

Primary endpoint:

dfs

powered for 20% improvement

From 29% to 48%

Slide16

GIST 3 v 5 year trial

SSG XXII

Recruiting in Glasgow, recruitment extended to March 2020

Have to have right pathology, mitotic rate and molecular analysis

4 patients on, a few more coming soon

Slide17

Deciphera

Phase 3DCC

2618 or

sunitinib

After

imatinib

failure

Open in Glasgow

Slide18

Voyager

Avapritinib v

Regorafanib

Advanced GIST

After

imatinib

, can have had up to 2 other

TKIs

Slide19

Radiotherapy trials

Only 1

Advent of protons in UK is likely to have an impact

Slide20

IMRiS

Radiotherapy

Planning, delivery and acute events

Largest cohort closed (STS limb)

Open still for:

Ewings

of pelvis or spine

Other bone tumours of Spine

Slide21

ICONIC

Osteosarcoma

In absence of a therapeutic trial

Data collection for all patients

Coupled with pathological material

May offer insights, allow identification of targets

Would like to open across Scotland

Slide22

TAPPAS

Angiosarocma

Pazopanib

v

pazo

plus something

Tried hard to open

Slide23

Larrys

Liposarcoma study

EORTC

1202

STBSG

Cabazitaxel

in metastatic or inoperable locally advanced de differentiated

Liposarocma

Phase II

Slide24

There are many others

Particularly early phase trials run in 1 or 2 centres

Look at:

CRUK

trials finder

Sarcoma UK website

NCRI

portfolio maps

or contact one of the London Oncologists