Unveiled in plenary conference of Asco 2018, a large European study shows that maintenance chemotherapy (1 year of treatment instead of 6 months) increases the survival of children and adolescents with a rare form of sarcoma called rhabdomyosarcoma.
In France, around 100 children and adolescents are affected by rhabdomyosarcoma each year. The tumor can be found anywhere in the body but mainly in the area of the head and neck, limbs and the urogenital sphere. “The standard management of children and adolescents with rhabdomyosarcoma at high risk of relapse consists of administering 9 courses of chemotherapy. Depending on the pathology and its location, surgery and radiotherapy can supplement the treatment. treatment, approximately 70% of patients recover “ explain the doctors by Gustave Roussy.
6-month maintenance chemotherapy
Initiated in 2005 by the European cooperative group EpSSG (European Pediatric Soft Tissue Sarcoma Study Group), this study sought to determine whether the extension of treatment by six months of maintenance chemotherapy (vinorelbine-cyclophosphamide) brought a benefit to children. To reach definite conclusions, it was necessary to include 370 children and adolescents aged 1 to 21 years.
Cyclophosphamide was administered daily orally (syrup or tablet depending on age) and vinorelbine administered as weekly injections.
“This daily maintenance chemotherapy had demonstrated its efficacy in relapse during a phase II clinical trial promoted by Gustave Roussy and initiated by Dr Odile Oberlin” specifies Dr Véronique Minard-Colin, pediatric oncologist in the child and adolescent oncology department at Gustave Roussy.
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During this maintenance phase, better tolerated than standard chemotherapy, children can resume their usually normal activity.
The results presented in the plenary session of ASCO reveal that this treatment increases the cure rate by approximately 13%. At 5 years of diagnosis, 86.5% of children treated with maintenance chemotherapy survived against 73.7% without maintenance treatment. On five-year recurrence-free survival, 69.8% of untreated children had not relapsed compared to 77.6% of children in the treated group. Following the results of this study, children and adolescents with rhabdomyosarcoma classified as high risk now receive 6-month maintenance chemotherapy after the first 6 months of induction therapy. In addition, this study will also change the standard of treatment for adults with rhabdomyosarcoma since approximately half of these cancers diagnosed in adults are of the pediatric type.
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