Alberto Pappo, MD, St. Jude Children’s Hospital, Memphis TN
Presented at the 2010 Texas Adolescent and Young Adult Oncology Conference hosted by Methodist Healthcare-San Antonio. October 2010.
11. Rhabdomyosarcoma Most common pediatric STS Heterogeneous, poor survival Collaboration in 1972 CCSG CALGB SWOG Over 4800 patients treated in 4 consecutive trials IRS (STS-COG)
15. Risk-Assignment in RMS Low: ~ 35% of RMS Favorable histology, site and lower Group/stage Intermediate: ~ 50% Non met ARMS Embryonalunresected and met < 10 yr High: ~ 15% of RMS Remaining metastatic disease 1.0 Low 0.8 Intermediate 0.6 Proportion FFS 0.4 High 0.2 0.0 8 10 0 2 4 6 Years
16. Intermediate Risk RMS FFS for patients with intermediate risk RMS has not improved 1.0 0.9 IRS-III (1984-1991) 0.8 0.7 IRS-IV (1991-1997) 0.6 Failure-Free Survival 0.5 0.4 0.3 0.2 0.1 0.0 0 1 2 3 4 5 Years
17. Survival of Patients with Metastatic RMS in IRS-III, IRS-IVP, and IRS IV (1984-1997) 1.0 0.9 0.8 0.7 0.6 Survival 0.5 0.4 IRS-III IRS-IVP 0.3 IRS-IV 0.2 p=0.61 0.1 0.0 0 1 2 3 4 5 Time
45. Combination therapy-why and which agents? One year, Dr. Flaherty thought, when he heard the news. Certainly no triumph. But it was something. Something to be built on. ''We just need,'' Dr. Flaherty said, ''to find the right combination.''
48. Incorporation of targeted therapies will improve the outcome of rhabdomyosarcoma: ARST08P1 - PI Suman Malempati * * * * * * Dexrazoxane with all Doxorubicin cycles # IMC-A12 held during XRT (Pilots 1 and 3)
49.
50. SARC 011 (R1507) trial 12/2007-8/09 111 eligible patients Age: 9-78 (median 26) 20% ≤ 18 yr 73 M; 81 W Bone (n=60) Primary (n=67); Secondary (n=44)
53. Conclusions STS account for 7-8% of cancers in AYA Clinical trial enrollment suboptimal Sample acquisition suboptimal Progress stalled Cooperation between adult and pediatric groups essential Consortia to study specific diseases