Full Title: rEECur: International Randomised Controlled Trial of Chemotherapy for the Treatment of Recurrent and Primary Refractory Ewing Sarcoma

Status: Active, Recruiting

Age Range: 4 - 50 years

Locations: Royal Marsden Hospital, Clatterbridge Cancer Centre, University College London Hospital, Royal Victoria Infirmary, Bristol Royal Hospital for Children, St James's University Hospital, Alder Hey Children's Hospital, Churchill Hospital, Christie Hospital, John Radcliffe Hospital, The Queen Elizabeth Hospital, Sheffield Children's Hospital, Bristol Haematology And Oncology Centre, Queen's Medical Centre, Nottingham, Leicester Royal Infirmary, Royal Marsden Hospital Sutton, Weston Park Hospital, Freeman Hospital, Addenbrooke's Hospital, Southampton General Hospital, Royal Manchester Childrens Hospital, Nottingham City Hospital, Leeds General Infirmary, Birmingham Children's Hospital

Trial Lead: Dr Martin McCabe

Ewing sarcoma is treated with a combination of surgery, chemotherapy or radiotherapy. However, if it does not respond to these treatments, or comes back afterwards, there isn’t a standard treatment for patients to receive.

rEECur is an international trial, which aims to compare different chemotherapy combinations or ‘regimens’ to find out which is most effective and/or has fewest side effects. Four chemotherapy regimens formed the four original trial ‘arms’ (the different options which participants could be assigned to), as listed below.

Following early analyses, three out of the four original arms have now closed to recruitment. So far, high dose Ifosfamide has proven to be the most effective option. A fifth chemotherapy arm (CE) has now been added to the study.

TOPOTECAN AND CYCLOPHOSPHAMIDE (TC) - update: this arm has been dropped.

IRINOTECAN AND TEMOZOLOMIDE (IT) - update: this arm has been dropped.

GEMCITABINE AND DOCETAXEL (GD) - update: this arm has been dropped.

HIGH DOSE IFOSFAMIDE (IFOS) – open

CARBOPLATIN + ETOPOSIDE (CE) – fifth arm, open, added at a later stage

The trial is being run as it is not known which is the best treatment for this group of patients. The trial is randomised, meaning patients will be randomly assigned to a treatment arm by a computer. This is done so that neither the patient nor their doctor will be able to influence which treatment arm the patient is given and means that the results of the trial are not biased in any way.

BCRT have recently awarded additional top-up funding for a targeted drug called Lenvatinib to be added to the trial, given in combination with high dose Ifosfamide (Lenvatinib + IFOS).

Lenvatinib is a type of drug known as a multi-tyrosine kinase inhibitor. It has demonstrated promising results when given alone (as a ‘single agent’) to patients whose Ewing sarcoma has returned. With this additional funding, the rEECur team will now test whether Levatinib given with chemotherapy is more effective than chemotherapy alone.

Approvals for this additional research have now been granted and recruitment to this arm will begin shortly. You can read more about this further research here.

The study is supported by the European Commission’s FP7 health programme, Cancer Research UK and The University of Birmingham. More information about the trial can be found on their website

If you would like any more information on clinical trials in general, please contact us at The Bone Cancer Research Trust.


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