The Scandinavian Sarcoma Group 25 Years´Jubilee Meeting St The Scandinavian Sarcoma Group 25 Years´Jubilee Meeting St. Petersburg, May 4-7, 2004

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Sarcoma tumor board Patient Treatment plan Orthopaedic surgeon Plastic Head & Neck Neuro Thorax Abdominal Cytologist Pathologist Cytogenetics X-ray diagnostician Patient Oncologist Treatment plan Surgery Radiotherapy: Preoperative Chemotherapy: Neoadjuvant Intraoperative Adjuvant Postoperative Intra-arterial Sequential Tumour necrosis factor a Brachytherapy isolated limb perfusion Hyperthermia Follow-up during and after treatment Centralized registration www.ssg-org.net

SSG Register Chairman H. Bauer Stockholm Coordinators K. Sundby Hall Oslo Ö. Berlin Gothenburg P. Gustafson Lund C. Trovik Bergen R. Huuhtanen Helsinki www.ssg-org.net

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Theses planed Leiomyosarcoma C. Svarvar, Helsinki Liposarcoma K. Engström, Gothenburg Chondrosarcoma B. Widhe, Stockholm Osteosarcoma C. Müller, Oslo Quality of life L. H. Aksnes, Oslo Skeletal metastases B. H. Hansen, Århus Radiation therapy and local recurrence in STS N. L. Jebsen, Bergen www.ssg-org.net

Soft Tissue Sarcoma SSG I Adjuvant chemotherapy in STS 1981 – 86 SSG V Treatment program for STS 1986 – SSG X Treatment of metastatic STS (VIG) 1991 – 97 SSG XII Metastasecetomy and CHT for lungmet. 1996 – 97 from STS. An EORTC/SSG randomized phase III study SSG XIII Treatment protocol for adults with 1998 – high-risk STS in extremities and trunk wall www.ssg-org.net

High-risk STS (SSG XIII) doxorubicin/ifosfamide Overall survival 5 4 3 2 1 1,0 ,9 ,8 ,7 ,6 ,5 ,4 ,3 ,2 ,1 3 - year OS: 77% Years Promising preliminary results but: Biased patient selection Short follow-up time Overall vs metastases-free survival

Adjuvant study for high-risk GIST SSG XVIII Adjuvant study for high-risk GIST R A N D O M I Z E Imatinib Follow-up 12 months 48 months 36 months 24 months Arm 1 Arm 2 Primary objective: To investigate the recurrence-free survival in GIST patients with a high (>50%) risk of disease recurrence within the first 5 years following the diagnosis and treated with adjuvant imatinib mesylate either for 12 or 36 months.

Osteosarcoma SSG II Combination therapy in OS 1982 – 1990 SSG VIII Therapy of OS 1990 – 1998 ISG/SSG I An Italian-Scandinavian treatment and 1997 – 2000 research protocol for high-grade osteosarcoma of the extremities ISG/SSG II Treatment of metastatic and pelvic 1998 – 2003 osteosarcoma SSG XIV A Scandinavian treatment research 2000 – 2004 protocol for extemity localized high- grade osteosarcoma Euroboss I A European treatment protocol for bone 2003 sarcoma in patients older than 40 years Euramos I An American/European treatment protocol 2004 for OS in patients <40 years www.ssg-org.net

European and American Osteosarcoma Study Group Euramos-1 A randomised trial of the European and American Osteosarcoma Study Group

EURAMOS 1 Euramos-1 Euramos-1 4 y anticipated accrual time (1400 pts). Covers a population >0.5 billion people Objectives Event-free survival Overall survival Short-term toxicity Long-term toxicity Quality-of-life Euramos-1 Optimize the treatment of patients suffering from osteosarcoma. Open for all patients with resectable high-grade osteosarcoma of the limbs or axial skeleton The trial takes into account the strong prognostic value of tumor response to preoperative chemotherapy and divides patients accordingly

Ewing´s sarcoma SSG IV Combined modality therapy in EWS 1984 – 90 SSG IX Therapy of EWS 1990 – 99 ISG/SSG III ISG/SSG treatment protocol for 1999 non-metastatic EWS ISG/SSG IV ISG/SSG treatment protocol for 1999 high-risk EWS www.ssg-org.net

Translational Sarcoma Research Future directions Cancer Registries Biobanks Translational Sarcoma Research www.ssg-org.net