Insulin-like Growth Factor Receptor Inhibition as Maintenance Therapy for Metastatic Ewing Sarcoma

J Pediatr Hematol Oncol. 2016 Oct;38(7):563-9. doi: 10.1097/MPH.0000000000000616.

Abstract

Despite the advances in oncology, the survival of children with Ewing Sarcoma metastatic at diagnosis continues to be 27% 3-year event-free survival and 34% 3-year overall survival. In other words, 7 of 10 children die within 3 years of their initial diagnosis despite intense chemotherapy, local treatment (radiation/surgery), and/or high dose busulfan-melphalan and autologous stem-cell transplantation. A chief contributor to this morbidity and mortality is the difficulty eradicating the tumor using present therapeutic modalities. Despite the extensive surgery, intensive chemotherapy and radiation, those left with a significant bulk of residual tumor relapse within a year of completing treatment. This case report suggests that in children left with a significant tumor burden after completing chemotherapy, a prolonged period of stability can be achieved with biological agents targeting the underlying molecular drivers. In this particular case we used figitumumab, an antibody targeting the insulin-like growth factor type 1 receptor pathway, a documented target in Ewing Sarcoma. Although not curative, these agents provide a better quality of life.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal / therapeutic use*
  • Bone Neoplasms / drug therapy*
  • Bone Neoplasms / mortality
  • Bone Neoplasms / pathology
  • Female
  • Humans
  • Receptors, Somatomedin / antagonists & inhibitors*
  • Sarcoma, Ewing / drug therapy*
  • Sarcoma, Ewing / mortality
  • Sarcoma, Ewing / secondary

Substances

  • Antibodies, Monoclonal
  • Receptors, Somatomedin
  • figitumumab