What’s new in Ewing tumor research and treatment?
Research on Ewing tumors is being done at many medical centers, university hospitals, and other institutions across the world.
Understanding and diagnosing Ewing tumors
Scientists are developing new techniques to more accurately diagnose Ewing tumors. New lab tests of tumor samples (see “How are Ewing tumors diagnosed?”) are being studied to see if they can help identify Ewing tumors and give more information on how well treatments might cure that particular tumor.
As researchers learn more about the changes inside Ewing tumor cells that make then different from normal cells, they hope to develop new treatments that take advantage of these changes (see below).
Researchers are looking to develop better treatments for Ewing tumors, as well as to find less toxic treatments for those that can be cured.
The Children’s Oncology Group, individual universities, and children’s hospitals are studying new chemotherapy combinations, which often include drugs such as topotecan, irinotecan, temozolomide, gemcitabine, docetaxel, and mithramycin (plicamycin).
Doctors are also trying to make the currently used drugs more effective by changing the way they are given. For example, they have found that giving the standard VAdriaC/IE chemo regimen more often – that is, every 2 weeks instead of every 3 weeks – seems to lower the chance of localized Ewing tumors coming back, without increasing the risk of serious side effects. This is often called compressed chemotherapy.
Researchers are also studying high-dose chemotherapy with stem cell transplants in those with Ewing tumors that are unlikely to be cured with current treatments.
As noted in the section “Do we know what causes Ewing tumors?”, great progress is being made in understanding the changes in genes and chromosomes that cause Ewing tumors to form.
This knowledge has already been used to develop very sensitive lab tests to detect this cancer, and doctors are now studying how to best use these tests to guide the choice of treatment. It might also lead to new drugs that target these changes in Ewing tumor cells.
Some new drugs that target specific changes in Ewing tumor cells are already being tested. For example, drugs that target the insulin-like growth factor receptor-1 (IGF-1R), a protein on some cancer cells that causes them to grow, are now being studied in clinical trials. Early studies have found that these drugs can shrink some Ewing tumors and slow down the growth of others. So far, this benefit has been temporary in most cases. These drugs may work best when combined with other drugs.
Other newer drugs being studied for use against Ewing tumors include:
- Drugs that affect a tumor’s ability to make new blood vessels, such as bevacizumab (Avastin)
- Drugs that target the mTOR protein, such as temsirolimus (Torisel) and everolimus (Afinitor)
- Drugs that target the PARP protein, such as olaparib and nipararib
- Drugs called HDAC inhibitors, such as vorinostat (Zolinza)
A newer approach to treatment is to try to get the body’s own immune system to recognize and attack the tumor cells. Some newer types of immune therapies have shown a great deal of promise in treating other types of cancer, and some of these approaches are now being looked at for Ewing tumors. These treatments are still in the early stages of testing at this time.
Last Medical Review: 09/18/2014
Last Revised: 02/04/2016