iCare 4 Ewing Sarcoma

Background 

Ewing sarcoma is an aggressive tumour of bone and soft tissue. Treatment is intensive and consists of combination of systemic therapy and local treatment (surgery and/or radiotherapy). Many trials have been performed in order to assess prognostic factors for survival outcomes. Assessment of these prognostic factors is important in predicting the effect of treatment on the course of the disease. Further, development of a prognostic model for both recurrence of disease (local, distant, or combined) and survival can assist in stratifying treatment according to individual risk profile. 

Aim

Identification of predictive clinical factors, development and validation of prediction models for survival outcome in Ewing sarcoma. These models will focus on different stages of the Ewing sarcoma therapy (patient presentation, choice of local treatment, follow-up) and will be built on the well-known methodology of multi-state models.

Relevance for cancer research 

The methodology of this research project can be applied to orphan cancerous diseases to be used by other multidisciplinary teams to improve prognosis and patient care. The models will be made available to other collaborating research groups.

Project Outcomes

• Liu C, Rueten-Budde AJ,  Ranft A, Dirksen U, Gelderblom  H & Fiocco M (2020). Dynamic prediction of overall survival: a retrospective analysis on 979 patients with Ewing sarcoma from the German registry. BMJ Open, 10:e036376. doi: 10.1136/bmjopen-2019-036376

• Bosma SE (2020, March 26). Individual clinical advanced decision-making and risk evaluation for Ewing sacoma. [Doctoral Thesis]

• Bosma SE, Vriens D, Gelderblom H, van de Sande MAJ, Dijkstra PDS & Bloem JL (2019). 18F-FDG PET-CT versus MRI for detection of skeletal metastasis in Ewing sarcoma. Skeletal Radiol, 48: 1735–1746. doi: 10.1007/s00256-019-03192-2 

• Bosma SE, Cleven AHG & Dijkstra PDS (2019).  Can Navigation Improve the Ability to Achieve Tumor-free Margins in Pelvic and Sacral Primary Bone Sarcoma Resections? A Historically Controlled Study. Clin Orthop Relat Res, 477(7):1548-1559. doi: 10.1097/CORR.0000000000000766

• Bosma SE, Rueten‐Budde AJ, Lancia C, Ranft A, Krol AD, Gelderblom H, van de Sande MAJ, Dijkstra PDS, Dirksen U & Fiocco M (2019). Individual risk evaluation for local recurrence and distant metastasis in Ewing sarcoma: A multistate model. Pediatr Blood Cancer, 66:e27943. doi: 10.1002/pbc.27943 

• Bosma SE, Lancia C, Rueten-Budde AJ, Ranft A, Gelderblom H, Fiocco M, van de Sande MAJ, Dijkstra PDS & Dirksen U (2019). Easy-to-use clinical tool for survival estimation in Ewing sarcoma at diagnosis and after surgery. Sci Rep 9, 11000. doi: 10.1038/s41598-019-46721-8 

• Bosma SE, Ayu O, Fiocco M, Gelderblom H. & Dijkstra PDS (2018). Prognostic factors for survival in Ewing sarcoma: A systematic review. Surg Oncol, 27(4):603- 610. doi: 10.1016/j.suronc.2018.07.016

Team

• S. Bosma, PhD candidate at the Department Medical Oncology, Leiden University Medical Center

• Prof. dr. P.D.S. Dijkstra, Orthopedic Surgeon at the Department Medical Oncology, Leiden University Medical Center

• Dr. M. Fiocco, Mathematical Institute Leiden University, Department of Biomedical Data Sciences Leiden University Medical Center & Princess Máxima Center for Pediatric Oncology 

• Prof. dr. H. Gelderblom, Medical Oncologist at the Department Medical Oncology, Leiden University Medical Center

• Dr. ir. C. Lancia, Mathematical Institute Leiden University