Maintenance therapy with oral cyclophosphamide plus celecoxib achievable in Ewing sarcoma

Maintenance therapy with oral cyclophosphamide plus celecoxib is achievable in patients with metastatic Ewing sarcoma, according to data presented at the 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Program.

Patients in this study underwent induction chemotherapy, radiotherapy and/or surgery at the site of the primary tumor, before a consolidation phase with high-dose busulphan/melphalan + autologous stem cell rescue, whole-lung irradiation (12-15Gy), and finally, a maintenance phase consisting of 180 days on cyclophosphamide 50 mg daily (35 mg/mq daily if age < 14 years) plus celecoxib 400 mg twice daily (250 mg/mq twice daily if age < 14 years).

Patients were excluded from the maintenance phase if their disease progressed or they had cardiac or gastro-intestinal comorbidity.

In total, 71 patients entered the maintenance phase; 61 eventually ended the maintenance phase, 4 were still on treatment, and 1 patient interrupted the treatment due to auto-immune thrombocytopenia. Disease progression/relapse cause 5 patients to withdrawn.

The duration of maintenance therapy was 89% of the scheduled days. The median suspension length was 12 days, with temporary suspensions resulting from hematological toxicity (19 episodes), infections (12 episodes), gastrointestinal disorders (9 episodes), fluid retention/distal oedema (3 episodes), renal disorders (3 episodes).

Reference

Puma N, et al. Maintenance therapy with oral cyclophosphamide plus celecoxib in patients with metastatic Ewing sarcoma: Results of the Italian Sarcoma Group/AIEOP EW-2 study. Presented at: 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Program; May 29-31.