Background and purpose of the project:
The addition of multi-targeted receptor tyrosine kinase inhibitors (mTKIs) to traditional chemotherapy is now being considered as a therapeutic option for Ewing sarcoma patients.
The rEECur clinical trial has recently started evaluating lenvatinib for recurrent and relapsed patients and the upcoming INTERWING-1 will introduce regorafenib for those patients diagnosed with metastatic disease.
Preclinical evidence suggests that some, but not all patients may respond to the addition of these targeted therapies to standard chemotherapy protocols; however, we still have no way of identifying which patients are likely to benefit.
Dr Paul Huang at the Institute of Cancer Research, London has previously identified patterns / signatures of biological markers which are present in tumours and is testing to see if these can be used to predict which sarcoma patients are most likely to respond to certain anticancer drugs.
The Bone Cancer Research Trust has awarded Dr Huang an Idea Grant to test if these biological markers could be used to identify Ewing sarcoma patients who would be likely to benefit from 2 multi-tyrosine kinase inhibitors: lenvatinib and regorafenib.
The main aims of the project are:
- A pilot study of biobanked samples obtained from patients with newly diagnosed and metastatic Ewing sarcoma to identify these biological markers.
- A pilot evaluation if these signatures can be used to predict response to regorafenib or lenvatinib in Ewing Sarcoma patients enrolled in the rEECur and INTER-EWING-1 clinical trials.
How could this project improve treatment options for Ewing sarcoma patients in the future?
This project aims to identify biological signatures for use in Ewing sarcoma which can help predict treatment response or risk of aggressive disease prior to starting treatment.
While this is a pilot study, it aims to generate important data that will hopefully lead to a more personalised approach to treatment in the years to come. The ultimate aim, through this project and future work in this area, is to ensure that regorafenib and lenvatinib are used effectively and in the patients that are most likely to respond to these treatments..