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Ambar NBD, de Seixas Alves MT, Lederman HM, Abib S, Duarte AAB, Caran EM. Irinotecan and vincristine for the treatment of refractory desmoplastic small round cell tumor in a developing country: a case report. J Med Case Rep 2019; 13:77. [PMID: 30851735 PMCID: PMC6409157 DOI: 10.1186/s13256-019-1985-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 01/17/2019] [Indexed: 01/06/2023] Open
Abstract
Introduction Desmoplastic small round cell tumor is an extremely rare and aggressive cancer that affects mainly adolescents and young adults. Despite multiple therapeutic strategies, most patients have resistant disease with very poor survival rates. Case presentation We present a case of a 10-year-old Caucasian boy with a desmoplastic small round cell tumor refractory to conventional treatment who exhibited a good response to alternative treatment. With use of irinotecan and vincristine in association with radiation therapy, a reduction of 96.9% of the dimensions of the target lesions compared with the initial image was observed. Conclusion This chemotherapy regimen, in association with radiation therapy, demonstrated efficacy for refractory desmoplastic small round cell tumor in our patient, and it is cost-effective.
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Affiliation(s)
| | | | | | - Simone Abib
- Instituto de Oncologia Pediátrica - UNIFESP, Sao Paulo, Brazil
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Les tumeurs desmoplastiques à petites cellules rondes de l’enfant, de l’adolescent et du jeune adulte. Bull Cancer 2018; 105:523-536. [DOI: 10.1016/j.bulcan.2018.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 01/15/2018] [Accepted: 01/19/2018] [Indexed: 12/31/2022]
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Bétrian S, Bergeron C, Blay JY, Bompas E, Cassier PA, Chevallier L, Fayette J, Girodet M, Guillemet C, Le Cesne A, Marec-Berard P, Ray-Coquard I, Chevreau C. Antiangiogenic effects in patients with progressive desmoplastic small round cell tumor: data from the French national registry dedicated to the use of off-labeled targeted therapy in sarcoma (OUTC's). Clin Sarcoma Res 2017; 7:10. [PMID: 28491276 PMCID: PMC5424317 DOI: 10.1186/s13569-017-0076-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 04/26/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Desmoplastic small round cell tumor (DSRCT) is a very rare mesenchymal tumor that mainly affects teenagers and young adults with a mean age at diagnosis around 20-25 years. Although initial management still needs standardization, many centers will use multimodal treatment including intensive chemotherapy, extensive surgical resection followed by radiotherapy. Despite this, prognosis remains very poor and the median overall survival is 25 months. Recurrent disease is mainly treated by chemotherapy. Recently, due to the unmet medical need for recurrent disease, targeted therapies were explored for DSRCT. METHODS In this study, we assessed the response rate and progression free survival in nine cases of progressive DSRCT included in the OUTC's registry and treated with antiangiogenics targeted agents (sunitinib, sorafenib and bevacizumab). OUTC's, a French national registry, collects data about the use of off-label targeted therapy in sarcoma. RESULTS Eight males and one woman were included, with median age at diagnosis of 27.3 years (range from 9 to 48 years). They received a mean 3 lines (2-5) of treatment before antiangiogenic agent initiation. Six patients received sunitinib, two received sorafenib and one bevacizumab. Median progression free survival was 3.1 months (range 2-5.5 months) and best response observed was 5.5 months stable disease. Most patients had manageable low-grade toxicities, mainly fatigue, abdominal pain and skin toxicity. CONCLUSIONS Despite very limited activity of antiangiogenics in our study, prospective collection of cases of these rare tumors together with molecular data should guide therapeutic decision and enhance outcome.
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Affiliation(s)
- Sarah Bétrian
- Departments of Oncology and Clinical Research, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, 1 avenue Irène Joliot-Curie, 31059 Toulouse Cedex, France
| | - Christophe Bergeron
- Departments of Oncology and Clinical Research, Centre Léon Berard and Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Jean-Yves Blay
- Departments of Oncology and Clinical Research, Centre Léon Berard, Lyon, France
| | - Emmanuelle Bompas
- Departments of Oncology and Clinical Research, Institut de Cancérologie de l'Ouest, Rene Gauducheau, St Herblain, France
| | - Philippe A Cassier
- Departments of Oncology and Clinical Research, Centre Léon Berard, Lyon, France
| | - Laure Chevallier
- Clinical Research Department, CRA, Centre Léon Berard, Lyon, France
| | - Jérome Fayette
- Departments of Oncology and Clinical Research, Centre Léon Berard, Lyon, France
| | - Magali Girodet
- Clinical Research Department, CRA, Centre Léon Berard, Lyon, France
| | - Cécile Guillemet
- Departments of Oncology and Clinical Research, Centre Henri Becquerel, Rouen, France
| | - Axel Le Cesne
- Departments of Oncology and Clinical Research, Institut Gustave Roussy, Paris, France
| | - Perrine Marec-Berard
- Departments of Oncology and Clinical Research, Centre Léon Berard and Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | | | - Christine Chevreau
- Departments of Oncology and Clinical Research, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, 1 avenue Irène Joliot-Curie, 31059 Toulouse Cedex, France
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Mora J, Modak S, Cheung NK, Meyers P, de Alava E, Kushner B, Magnan H, Tirado OM, Laquaglia M, Ladanyi M, Rosai J. Desmoplastic small round cell tumor 20 years after its discovery. Future Oncol 2016; 11:1071-81. [PMID: 25804122 DOI: 10.2217/fon.15.32] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Desmoplastic small round cell tumor (DSRCT) was proposed as a distinct disease entity by William L Gerald and Juan Rosai in 1991. Over 850 patients have been reported in the medical literature. A specific translocation, t(11;22)(p13;q12), is seen in almost all cases, juxtaposing the EWS gene to the WT1 tumor suppressor gene. DSRCT is composed of nests of small round cells with polyphenotypic differentiation, typically a mixture of epithelial, mesenchymal and neural features, surrounded by a prominent desmoplastic stroma. DSRCT has a predilection for adolescent and young adult males, and primarily involves the abdominal cavity and pelvis. Survival is low despite their initial response to multimodal treatment. Most patients relapse with disseminated disease that is unresponsive to further therapy.
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Affiliation(s)
- Jaume Mora
- Department of Pediatric Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
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