Rhabdomyosarcoma: Still Unresolved Questions but New Perspectives

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Molecular Cancer Biology".

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 7945

Special Issue Editors


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Guest Editor
1.Klinikum Stuttgart, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), 70174 Stuttgart, Germany
2. Medical Faculty, University of Tübingen, 72076 Tübingen, Germany
Interests: soft tissue sarcoma; pediatric solid tumors; rhabdomyosarcoma; innovative therapies; molecular profiling; molecular classification of pediatric soft tissue sarcoma; liquid biopsy

E-Mail Website
Guest Editor
1.Klinikum Stuttgart, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), 70174 Stuttgart, Germany
2. Medical Faculty, University of Tübingen, 72076 Tübingen, Germany
Interests: soft tissue sarcoma; pediatric solid tumors; rhabdomyosarcoma; innovative therapies; molecular profiling; molecular classification of pediatric soft tissue sarcoma; liquid biopsy

Special Issue Information

Dear Colleagues,

Rhabdomyosarcoma (RMS) is a rare mesodermal tumor that can occur at any age but which is mostly diagnosed in children and adolescents. The cure rates for RMS have increased from 25% in the 1970s to 70% in 1990 due to the efforts of cooperative groups on both sides of the Atlantic. This improvement has mainly been achieved in children and adolescents who were eligible for pediatric clinical trials. Young and elderly adults still have poor outcomes. Similarly, no significant progress has been achieved in patients with metastatic disease. Four major RMS histologic subtypes exist: embryonal, alveolar, pleomorphic, and spindle cell RMS. In the majority of alveolar RMS fusion genes, PAX3/7-FOXO1 are detected. However, there is little known regarding phenotypic and biological heterogeneity across the RMS spectrum, especially for fusion-negative RMS. The recent risk grouping system used to adapt the therapy burden is based on clinical features, pathological subtypes, and PAX3/7-FOXO1 fusion status. However, the stratification parameters do not include the full range of the genetic variability of RMS.

The long-term sequelae remain a major problem in survivors. The current trend is to deescalate chemotherapy and radiotherapy treatment, as many trials in the past have failed to show improved outcomes by increasing the dose administered or providing additional drugs. Special consideration must be given to developing better cooperation with medical oncologists, including young adults in pediatric trials, and developing treatment recommendations for adult patients with biologically different RMS, including recommendations for the lifelong surveillance of survivors of RMS.

For this Special Issue, we welcome original and review papers focusing on the understanding of the genomic landscape and underlying biological mechanisms to identify objective biomarkers for the better stratification and monitoring of therapy and the identification of novel therapeutic targets and therapies. We look also for papers on the late effects and quality of life of RMS long-term survivors in the context of reducing the sequelae through the use of optimal-risk adapted local and systemic therapy. Articles providing solutions for developing overarching trials for all ages are also welcome.

We look forward to receiving your contributions.

Prof. Dr. Ewa Koscielniak
Dr. Monika Sparber-Sauer
Guest Editors

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Keywords

  • rhabdomyosarcoma
  • molecular characterization
  • late effects
  • RMS predisposition
  • innovative therapies

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Published Papers (3 papers)

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Research

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14 pages, 3978 KiB  
Article
Pediatric Patients with Stage IV Rhabdomyosarcoma Significantly Benefit from Long-Term Maintenance Therapy: Results of the CWS-IV 2002 and the CWS DOK IV 2004-Trials
by Lars Tramsen, Konrad Bochennek, Monika Sparber-Sauer, Emilia Salzmann-Manrique, Monika Scheer, Tobias Dantonello, Arndt Borkhardt, Uta Dirksen, Anne Thorwarth, Jeanette Greiner, Martin Ebinger, Jadwiga Weclawek-Tompol, Ruth Ladenstein, Gustaf Ljungman, Erika Hallmen, Thomas Lehrnbecher, Ewa Koscielniak and Thomas Klingebiel
Cancers 2023, 15(7), 2050; https://doi.org/10.3390/cancers15072050 - 30 Mar 2023
Cited by 6 | Viewed by 3210
Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma (STS) in childhood. Whereas more than 90% of patients with localized low-risk RMS can be cured, metastatic RMS have a dismal outcome, with survival rates of less than 30%. The HD CWS-96 trial showed [...] Read more.
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma (STS) in childhood. Whereas more than 90% of patients with localized low-risk RMS can be cured, metastatic RMS have a dismal outcome, with survival rates of less than 30%. The HD CWS-96 trial showed an improved outcome for patients receiving maintenance therapy after completing intensive chemotherapy. Consequently, the international clinical trials CWS-IV 2002 and CWS DOK IV 2004 on metastatic disease of STS of the Cooperative Weichteilsarkom Studiengruppe (CWS) were designed in addition to the CWS-2002P trial for localized RMS disease. All patients received a multimodal intensive treatment regimen. To maintain remission, three options were compared: long-term maintenance therapy (LTMT) versus allogeneic hematopoietic stem cell transplantation (alloHSCT) versus high-dose chemotherapy (HDCT). A total of 176 pediatric patients with a histologically confirmed diagnosis of metastatic RMS or RMS-like tumor were included. A total of 89 patients receiving LTML showed a significantly better outcome, with an event-free survival (EFS) of 41% and an overall survival (OS) of 53%, than alloHSCT (n = 21, EFS 19%, p = 0.02, OS 24%, p = 0.002). The outcome of LTML was slightly improved compared to HDCT (n = 13, EFS 35%, OS 34%). In conclusion, our data suggest that in patients suffering from metastatic RMS, long-term maintenance therapy is a superior strategy in terms of EFS and OS compared to alloHSCT. EFS and OS of HDCT are similar in these strategies; however, the therapeutic burden of LTMT is much lower. Full article
(This article belongs to the Special Issue Rhabdomyosarcoma: Still Unresolved Questions but New Perspectives)
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14 pages, 1148 KiB  
Article
Patterns of Hearing Loss in Irradiated Survivors of Head and Neck Rhabdomyosarcoma
by Franciscus A. Diepstraten, Jan Wiersma, Reineke A. Schoot, Rutger R. G. Knops, Charlotte L. Zuur, Annelot J. M. Meijer, Raquel Dávila Fajardo, Bradley R. Pieters, Brian V. Balgobind, Henrike Westerveld, Nicole Freling, Harm van Tinteren, Ludwig E. Smeele, Arjan Bel, Marry M. van den Heuvel-Eibrink, Robert J. Stokroos, Johannes H. M. Merks, Alexander E. Hoetink and Marinka L. F. Hol
Cancers 2022, 14(23), 5749; https://doi.org/10.3390/cancers14235749 - 23 Nov 2022
Cited by 1 | Viewed by 1956
Abstract
Purpose: The frequency and patterns of HL in a HNRMS survivor cohort were investigated. A dose–effect relationship between the dose to the cochlea and HL was explored. Methods: Dutch survivors treated for HNRMS between 1993 and 2017 with no relapse and at least [...] Read more.
Purpose: The frequency and patterns of HL in a HNRMS survivor cohort were investigated. A dose–effect relationship between the dose to the cochlea and HL was explored. Methods: Dutch survivors treated for HNRMS between 1993 and 2017 with no relapse and at least two years after the end of treatment were eligible for inclusion. The survivors were evaluated for HL with pure-tone audiometry. HL was graded according to the Muenster, Common Terminology Criteria for Adverse Events (CTCAE) v4.03 and International Society for Paediatric Oncology (SIOP) classification. We defined deleterious HL as Muenster ≥ 2b, CTCAE ≥ 2, and SIOP ≥ 2. Mixed-effects logistic regression was used to search for the dose–effect relationship between the irradiation dose to the cochlea and the occurrence of HL. Results: Forty-two HNRMS survivors underwent pure-tone audiometry. The Muenster, CTCAE and SIOP classification showed that 19.0% (n = 8), 14.2% (n = 6) and 11.9% (n = 5) of survivors suffered from HL, respectively. A low-frequency HL pattern with normal hearing or milder hearing loss in the higher frequencies was seen in four survivors. The maximum cochlear irradiation dose was significantly associated with HL (≥Muenster 2b) (p = 0.047). In our series, HL (≥Muenster 2b) was especially observed when the maximum dose to the cochlea exceeded 19 Gy. Conclusion: HL occurred in up to 19% of survivors of HNRMS. More research is needed on HL patterns in HNRMS survivors and on radiotherapy dose–effect relationships. Full article
(This article belongs to the Special Issue Rhabdomyosarcoma: Still Unresolved Questions but New Perspectives)
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Review

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15 pages, 327 KiB  
Review
Clinical Characteristics, Treatment Considerations, and Outcomes of Infants with Rhabdomyosarcoma
by Adam P. Yan, Rajkumar Venkatramani, Julie A. Bradley, Timothy B. Lautz, Cristian I. Urla, Johannes H. M. Merks and Sapna Oberoi
Cancers 2023, 15(8), 2296; https://doi.org/10.3390/cancers15082296 - 14 Apr 2023
Cited by 2 | Viewed by 1925
Abstract
RMS most commonly presents in children and adolescents, however a subset of tumors are diagnosed in infants under one year of age. Due to the rarity of infant RMS, utilization of different treatment approaches and goals, and small sample sizes, the published studies [...] Read more.
RMS most commonly presents in children and adolescents, however a subset of tumors are diagnosed in infants under one year of age. Due to the rarity of infant RMS, utilization of different treatment approaches and goals, and small sample sizes, the published studies of infants with RMS have yielded heterogeneous results. In this review, we discuss the outcomes of infants with RMS treated in various clinical trials and the strategies that various international cooperative groups have employed to reduce the morbidity and mortality related to treatment without compromising the overall survival of this population. This review discusses the unique scenarios of diagnosing and managing congenitals or neonatal RMS, spindle cell RMS and relapsed RMS. This review concludes by exploring novel approaches to diagnosis and management of infants with RMS that are currently being studied by various international cooperative groups. Full article
(This article belongs to the Special Issue Rhabdomyosarcoma: Still Unresolved Questions but New Perspectives)
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