Trials Update May 2019

EuroEwings 2012

EE 2012 Now closed, R1 recruited over its target of 600 Webex meetings ? Next week Letter to investigators VDC/IE is superior to VIDE induction Next first line Ewings trial still in development Good UK recruitment Biological samples – good, not great

Local control audit RT alone 22% Surgery alone 28% Both 50%

RECCUR

RECCUR Relapsed Ewings Measurable disease, biological, QoL 4 arms: can elect not to use 1 for specific patient Irinotecan/Temozolomide Ifosfamide Gemcitabine/Docetaxel (poorer RR and efs) Cyclophosphamide/Topotecan

Quality of Life SAM – Sarcoma Assessment Measure EORTC - in development

SAM Sarcoma Assessment Measure Developing a QoL tool for Sarcoma In phase II (1000 pts) Hope that this will be available for use in trials 40 for Glasgow

Rhabdomyosarcoma Long running trials Most participants are paediatric Guide our adult practice RMS 2005 EpSSG etc

FaR RMS Children and young adults (? Up to 29) Alveolar and Embryonal (based on fusion status) All stages PET CT at diagnosis Very complicated RT section with randomisations

FaR RMS Very high risk: IVADo +/- irinotecan High Risk: IVA +/- irinotecan Maintenance: 6 v 12 v 24 months Cyclo/Vin Risk group dependant Relapse: VI v VIT or similar (? Regorafanib)

Retroperitoneal Sarcoma Interest in improving outcomes by adding something to surgery Various papers, single institution publications Conflicting outcomes Previous American Study failed to recruit

STRASS 1 Operable retroperitoneal sarcoma RT pre op or no radiotherapy No safety concerns between the 2 arms Still not reported, due at ASCO next month Tried to open, too difficult to get through RT dept

STRASS 2 In development, final protocol soon. Chemotherapy question. PET CT, MRI, Biological Neoadj chemo x 3 for operable High grade Leiomyosarcoma (DTIC/adria) High grade and De diff Liposarcoma (ifos/adria) Primary endpoint: dfs powered for 20% improvement From 29% to 48%

GIST 3 v 5 year trial SSG XXII Recruiting in Glasgow, recruitment extended to March 2020 Have to have right pathology, mitotic rate and molecular analysis 4 patients on, a few more coming soon

Deciphera Phase 3 DCC 2618 or sunitinib After imatinib failure Open in Glasgow

Voyager Avapritinib v Regorafanib Advanced GIST After imatinib, can have had up to 2 other TKIs

Radiotherapy trials Only 1 Advent of protons in UK is likely to have an impact

IMRiS Radiotherapy Largest cohort closed (STS limb) Open still for: Planning, delivery and acute events Largest cohort closed (STS limb) Open still for: Ewings of pelvis or spine Other bone tumours of Spine

ICONIC Osteosarcoma In absence of a therapeutic trial Data collection for all patients Coupled with pathological material May offer insights, allow identification of targets Would like to open across Scotland

TAPPAS Angiosarocma Pazopanib v pazo plus something Tried hard to open

Larrys Liposarcoma study EORTC 1202 STBSG Cabazitaxel in metastatic or inoperable locally advanced de differentiated Liposarocma Phase II

There are many others Particularly early phase trials run in 1 or 2 centres Look at: CRUK trials finder Sarcoma UK website NCRI portfolio maps or contact one of the London Oncologists