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Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.

Contact Information:

Prof Martin McCabe
+44 (0) 121 415 9877
reecur@trials.bham.ac.uk


More information about this study, what is involved and how to take part can be found on the study website.

Study Location:

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Be Part of Research - Trial Details - Chemotherapy for the treatment of recurrent and primary refractory Ewing sarcoma

Chemotherapy for the treatment of recurrent and primary refractory Ewing sarcoma

Medical Conditions

Paediatrics, Recurrent/refractory Ewing sarcoma


This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.


Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.  

The recruitment start and end dates are as follows:

01 Dec 2014 30 Sep 2025

Interventional

Intervention Type : Drug
Intervention Description : Current intervention as of 10/01/2025: At trial entry, patients will be randomised to one of the available chemotherapy regimens:1. High dose Ifosfamide (IFOS): 4 cycles of 21 days, additional cycles at clinician's discretion.2. High dose Ifosfamide and Lenvatinib (IFOS-L): 4 cycles of 21 days, additional IFOS cycles at clinician’s discretion. Lenvatinib capsules are taken once daily continuously throughout and for up to 2 years in total.

Local disease control measures are encouraged where possible. However, these should be delayed if possible until the completion of protocol-defined treatment (4 cycles of IFOS) or completion of 4 IFOS cycles for patients on IFOS-L.

Stem cell harvesting may be carried out in patients for whom high-dose therapy is planned. However, if an alternative chemotherapy regimen is planned for stem cell mobilisation, it should be delayed if possible until completion of protocol-defined treatment, (i.e after completion of IFOS-L or, 6 cycles ofCE or, 4 cycles of IFOS) or as a minimum must be delayed until after the response assessment following cycle 4. Patients who continue to receive Lenvatinib (see section 7.2.3.5) should not receive chemotherapy other than ifosfamide at the protocol-defined dose. If these are planned, lenvatinib must be permanently discontinued prior to treatment.

Myeloablative therapy may be given at the discretion of the treating physician after 6 cycles of CE or after 4 cycles of IFOS. High-dose therapy may not be given simultaneously with lenvatinib. If high-dose therapy is planned, lenvatinib must be permanently discontinued beforehand.





Previous intervention:At trial entry patients will be randomised to one of four chemotherapy regimens:1. Topotecan and cyclophosphamide (TC): 6 cycles. Additional cycles may be given at the discretion of the treating clinician.2. Irinotecan and temozolomide (IT): 6 cycles. Additional cycles may be given at the discretion of the treating clinician.3. Gemcitabine and docetaxel (GD): 6 cycles. Additional cycles may be given at the discretion of the treating clinician.4. High-dose Ifosfamide (IFOS): 4 cycles.

Clinicians are encouraged to use local disease control measures where possible after four cycles of chemotherapy. Stem cell harvesting may be carried out in patients for whom high-dose therapy is planned but the first four chemotherapy cycles must be given according to the randomised regimen. Patients randomised to receive TC, IT or GD who have not progressed on treatment may continue to receive the randomised regimen for more than six cycles at the discretion of the treating physician. Myeloablative therapy may be given at the discretion of the treating physician after six cycles of TC, IT or GD, or after four cycles of IFOS.




You can take part if:



You may not be able to take part if:


Current participant exclusion criteria (since 03-May-2023) as of 10/01/2025: 1. Absolute Neutrophil Count (ANC) <1.0 x 109/L or platelets <75 x 109/L.2. Cytotoxic chemotherapy or other investigational medicinal product (IMP) within the previous two weeks.3. Myeloablative therapy within the previous eight weeks.4. Radiotherapy to target lesion within the previous six weeks.5. Pregnant or breastfeeding women.6. Pre-existing medical condition that would necessitate a dose modification during cycle 1 as described in section 7.7. Any central neurotoxicity with previous ifosfamide treatment8. Clinical evidence of nephrotic syndrome9. Follow-up is not possible due to social, geographic or psychological reasons.10. Previous randomisation into the rEECur trial11. Patients with a contraindication or hypersensitivity to any IMP may not be randomised to receive an arm that contains the contraindicated IMP.12. Patients who have previously received one of the trial regimens off-trial may not be randomised to receive that regimen again. Patients who have had ifosfamide during first-line therapy may receive the IFOS or IFOS-L arm. There is no requirement for a minimum time between receiving first-line ifosfamide and entry to rEECur.

Additional exclusion criteria for the IFOS-L arm: 1. Clinically significant ECG abnormality, including a marked baseline prolonged QT or QTc interval (eg, a repeated demonstration of a QTc interval >480 msec).2. History of aneurysm3. Arterial Thromboembolism in previous 6 months4. Gastrointestinal or non-gastrointestinal fistula.5. Gastrointestinal bleeding or active haemoptysis within the previous 3 weeks6. Major surgery within the previous 3 weeks7. Previous treatment with tyrosine kinase inhibitors8. Radiographic evidence of intratumoral cavitation, encasement, or invasion of a major blood vessel, or proximity to major blood vessels with the potential risk of severe haemorrhage associated with tumor shrinkage/necrosis after lenvatinib therapy.

Previous participant exclusion criteria as of 14/12/2018:1. Bone marrow infiltration resulting in Absolute Neutrophil Count (ANC) <1.0 x 109/L or platelets <75 x 109/L.2. Cytotoxic chemotherapy or other investigational medicinal product (IMP) within previous two weeks.3. Myeloablative therapy within previous eight weeks.4. Radiotherapy to target lesion within previous six weeks.5. Pregnant or breastfeeding women.6. Follow-up not possible due to social, geographic or psychological reasons.7. Previous randomisation into the rEECur trial

Additional criteria for specific arms:1. Patients with a contraindication to any IMP may be entered into the study but may not be randomised to receive an arm that contains a contraindicated IMP. They will be eligible for trial entry as long as they can be randomised between a minimum of two study arms.2. Patients who are unable to receive one or more IMPs due to local or national funding arrangements will be eligible for trial entry as long as they can be randomised between a minimum of two study arms.3. Patients and investigators may decline randomisation to one or more trial regimens but will be eligible for trial entry as long as they can be randomised between a minimum of two study arms.4. Patients who have previously received one of the trial regimens off-trial may not be randomised to receive that chemotherapy regimen again. However, patients who have received cyclophosphamide during first line therapy may be randomised to receive the TC arm and patients who have had ifosfamide during first line therapy may receive the ifosfamide arm if they do not have pre-existing renal or other toxicity that would necessitate in rEECur a dose modification. There is no requirement for a minimum time between receiving first line ifosfamide and entry to rEECur.

Previous participant exclusion criteria:1. Conventional dose cytotoxic chemotherapy or other investigational medicinal product (IMP) within previous four weeks2. Myeloablative dose chemotherapy within previous 8 weeks3. Radiotherapy to target lesions within previous 6 weeks4. Pregnant or breastfeeding women5. Follow-up not possible due to social, geographic or psychological reasons

Additional criteria for specific arms:1. Patients who have previously received one of the randomised regimens may not be randomised to receive that chemotherapy regimen again2. Patients with a contraindication to any IMP may be entered into the study but may not be randomised to receive an arm that contains a contraindicated IMP3. Patients who have received cyclophosphamide during first-line therapy may be randomised to receive the TC arm4. Patients who have had ifosfamide during first-line therapy may be randomised to receive the IFOS arm if they do not have pre-existing renal or other toxicity that would necessitate a dose modification. There is no requirement for a minimum time between receiving first-line ifosfamide and randomisation to IFOS as part of the rEECur trial.


Below are the locations for where you can take part in the trial. Please note that not all sites may be open.

  • Beatson West of Scotland Cancer Centre
    1053 Great Western Road
    Glasgow
    G12 0YN
  • Weston Park Hospital
    Whitham Road
    Sheffield
    S10 2SJ
  • Royal Victoria Infirmary
    Queen Victoria Road
    Newcastle upon Tyne
    NE1 4LP
  • St James's University Hospital
    Beckett Street
    Leeds
    LS9 7TF
  • Southampton General Hospital
    Tremona Road
    Southampton
    SO16 6YD
  • Nottingham City Hospital
    Hucknall Road
    Nottingham
    NG5 1PB
  • Leeds General Infirmary
    Great George Street
    Leeds
    LS1 3EX
  • Leicester Royal Infirmary
    Infirmary Square
    Leicester
    LE1 5WW
  • Queen's Medical Centre
    Derby Road
    Nottingham
    NG7 2UH
  • Addenbrooke's Hospital
    Hills Road
    Cambridge
    CB2 0QQ
  • University College London Hospital
    235 Euston Road
    London
    NW1 2BU
  • Churchill Hospital
    Old Road
    Oxford
    OX3 7LE
  • Noah's Ark Children's Hospital for Wales
    Heath Park Way
    Cardiff
    CF14 4XW
  • Royal Aberdeen Children's Hospital
    Westburn Road
    Aberdeen
    AB25 2ZG
  • John Radcliffe Hospital
    Headley Way, Headington
    Oxford
    OX3 9DU
  • Alder Hey Children's Hospital
    Eaton Road
    Liverpool
    L12 2AP
  • Christie Hospital
    Manchester
    M20 4BX
  • Bristol Royal Hospital for Children
    Upper Maudlin Street
    Bristol
    BS2 8BJ
  • Clatterbridge Cancer Centre
    Clatterbridge Road
    Birkenhead
    CH63 4JY
  • Freeman Hospital
    Freeman Road, High Heaton
    Newcastle upon Tyne
    NE7 7DN
  • Royal Belfast Hospital for Sick Children
    180 Falls Road
    Belfast
    BT12 6BE
  • Royal Hospital for Children Glasgow
    1345 Govan Road
    Glasgow
    G51 4TF
  • Royal Hospital for Sick Children Edinburgh
    9 Sciennes Road
    Edinburgh
    EH9 1LF
  • Royal Manchester Childrens Hospital
    Oxford Road
    Manchester
    M13 9WL
  • Royal Marsden Hospital London
    203 Fulham Road
    London
    SW3 6JJ
  • Royal Marsden Hospital Sutton
    Downs Road
    Sutton
    SM2 5PT
  • Sheffield Children's Hospital
    The Mount, Glossop Road
    Sheffield
    S10 3FL
  • The Queen Elizabeth Hospital
    Mindelsohn Way
    Birmingham
    B15 2TH
  • Hospital Universitari Vall D'hebron
    119-129
    Barcelona
    08035
  • Istituto Ortopedico Rizzoli
    Via Giulio Cesare Pupilli, 1
    Bologna
    40136
  • Helsinki Children's Hospital
    Stenbäckinkatu 11
    Helsinki
    00290
  • Oslo University Hospital
    Sognsvannsveien 20
    Oslo
    0372
  • University Hospital Rigshospitalet
    Blegdamsvej 9
    København
    2100
  • Institut Gustave Roussy
    114 Rue Edouard Vaillant
    Villejuif
    94800
  • Semmelweiss Universitat Ii
    Üllői út 26
    Budapest
    1085
  • U.Z Leuven- Campus Gasthuisberg
    Herestraat 49
    Leuven
    3000
  • Maria Sklodowska-curie Memorial Cancer Center and Institute of Oncology
    Wawelska 15 B
    Warszawa
    00-001
  • University Hospital Motol
    V Úvalu 84
    Praha
    150 06
  • Leiden University Medical Centre
    Albinusdreef 2
    Leiden
    2333 ZA
  • Princess Margaret Hospital
    Roberts Road, Subiaco
    Perth
    6008
  • Starship Children’s Hospital
    2 Park Road, Grafton
    Auckland
    1023
  • Universitäts Kinderspital beider Basel
    Spitalstrasse 33
    Basel
    4056
  • Birmingham Children's Hospital
    Steelhouse Lane
    Birmingham
    B4 6NH

This information has not yet been provided by the study team. You'll have an opportunity to discuss any risks and benefits that may be associated with this study prior to consenting to taking part.

Prof Martin McCabe
+44 (0) 121 415 9877
reecur@trials.bham.ac.uk



More information about this study, what is involved and how to take part can be found on the study website.


The study is sponsored by University of Birmingham (UK) and funded by Seventh Framework Programme.




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Read full details for Trial ID: ISRCTN36453794
Last updated 10 January 2025

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