1) To co-ordinate randomized controlled trials of therapy in patients with Ewings sarcoma.
2) To complete, analyse and publish EICESS 92 Study.
3) To design and initiate EICESS 98 Study including the integration of biological studies.
Ewings sarcoma is one of the two common forms of bone cancer in young people. The EICESS group was established in 1990 with the aim of bringing together two of the major European Groups concerned with the management of this tumour into a group large enough to undertake randomized controlled trials of therapy with the aim of improving prognosis and reducing morbidity. The EICESS 92 trial was the first study undertaken by this group and this consisted of two separate, but linked, studies relating to standard risk (tumours <100 ml) and high risk. The standard risk study is accruing patients at the expected rate and will require a further 4 years to complete. The initial question posed for the study i.e. "can survival be maintained whilst reducing morbidity" remains valid. The high-risk study will be completed during 1998 and then analyzed and published. A new study, EICESS 98, is in the process of being developed. Patients will be stratified according to risk criteria developed from the EICESS 92 study and the combined EICESS data set of all patients treated by group members since 1978. There have been major advances in the understanding of the biology of Ewings sarcoma over the past three years. One of the major findings has been the definition of specific fusion transcripts in Ewing's sarcoma cells and also that these can be identified by reverse transcription polymerase chain reaction (RT-PCR) in both blood and bone marrow.
The EICESS 98 study will include an investigation of these new biological factors with a specific aim of:
A. determining whether any specific fusion transcripts are associated with treatment outcome
B. to understand whether the finding of RT-PCR positive blood and/or bone marrow can
identify patients at high risk of relapse.
Ewings sarcoma, chemotherapy, randomized controlled trials, cancer