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Pazopanib maintenance therapy after tandem high-dose chemotherapy for disseminated Ewing sarcoma

  • Akihiro TamuraEmail author
  • Nobuyuki Yamamoto
  • Nanako Nino
  • Takayuki Ichikawa
  • Naoko Nakatani
  • Sayaka Nakamura
  • Atsuro Saito
  • Aiko Kozaki
  • Kenji Kishimoto
  • Toshiaki Ishida
  • Makiko Yoshida
  • Yoshinobu Akasaka
  • Daiichiro Hasegawa
  • Yoshiyuki Kosaka
Case report

Abstract

The dismal prognosis of patients with disseminated Ewing sarcoma necessitates the development of novel treatment strategies. Pazopanib is an oral multi-targeted tyrosine kinase inhibitor that is active against advanced soft tissue sarcoma. However, the clinical activity and feasibility of pazopanib for treating Ewing sarcoma remain poorly understood. Moreover, clinical information on the use of tandem high-dose chemotherapy for Ewing sarcoma is limited. A 14-year-old boy with Ewing sarcoma was transferred to our hospital for treatment. Magnetic resonance imaging, computed tomography scans, and bone scintigraphy revealed multiple lesions in the pubis, ilium, ischium, femur, rib, cranial bone, thoracic vertebrae, sacrum, obturator muscle, adductor magnus muscle, testicular cord, and lungs. Bone scintigraphy after intensive chemotherapies confirmed that multiple abnormal accumulations were still present in the cranial bone and pubis. Subsequently, the patient received tandem high-dose chemotherapy including topotecan, and radiotherapy. Abnormal accumulations have disappeared in bone scintigraphy. Subsequently, pazopanib maintenance therapy was initiated. Despite the presence of innumerable lesions at diagnosis, the patient has been in near-complete remission for the past 1 year with pazopanib administration. This confirms that adding pazopanib maintenance therapy after tandem high-dose chemotherapy is a therapeutic option for cases with disseminated Ewing sarcoma.

Keywords

Disseminated Ewing sarcoma Pazopanib Tandem high-dose chemotherapy 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to disclose. This study was conducted in accordance with the Declaration of Helsinki. Written and oral informed consent for publication was obtained from the patient’s guardians.

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Copyright information

© The Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Akihiro Tamura
    • 1
    Email author
  • Nobuyuki Yamamoto
    • 1
  • Nanako Nino
    • 1
  • Takayuki Ichikawa
    • 1
  • Naoko Nakatani
    • 1
  • Sayaka Nakamura
    • 1
  • Atsuro Saito
    • 1
  • Aiko Kozaki
    • 1
  • Kenji Kishimoto
    • 1
  • Toshiaki Ishida
    • 1
  • Makiko Yoshida
    • 2
  • Yoshinobu Akasaka
    • 3
  • Daiichiro Hasegawa
    • 1
  • Yoshiyuki Kosaka
    • 1
  1. 1.Department of Hematology and OncologyKobe Children’s HospitalKobeJapan
  2. 2.Department of Diagnostic PathologyKobe Children’s HospitalKobeJapan
  3. 3.Department of Diagnostic RadiologyKobe Children’s HospitalKobeJapan

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