TY - JOUR A1 - Sparber‐Sauer, Monika A1 - Ferrari, Andrea A1 - Kosztyla, Daniel A1 - Ladenstein, Ruth A1 - Cecchetto, Giovanni A1 - Kazanowska, Bernarda A1 - Scarzello, Giovanni A1 - Ljungman, Gustaf A1 - Milano, Giuseppe Maria A1 - Niggli, Felix A1 - Alaggio, Rita A1 - Vokuhl, Christian A1 - Casanova, Michela A1 - Klingebiel, Thomas A1 - Zin, Angelica A1 - Koscielniak, Ewa A1 - Bisogno, Gianni T1 - Long‐term results from the multicentric European randomized phase 3 trial CWS/RMS‐96 for localized high‐risk soft tissue sarcoma in children, adolescents, and young adults N2 - Background: CWS/RMS‐96 was an international multicenter trial with randomization between two therapy arms of the standard four‐drug therapy (vincristine, ifosfamide, adriamycin, dactinomycin [VAIA]) versus an intensified six‐drug regimen (carboplatin, epirubicin, vincristine, dactinomycin, ifosfamide, and etoposide [CEVAIE]) for high‐risk rhabdomyosarcoma (RMS), extraskeletal Ewing sarcoma (EES), and undifferentiated sarcoma (UDS) in children, adolescents, and young adults aiming to improve their survival. Intensified chemotherapy with CEVAIE did not improve outcome. Methods: Patients younger than 21 years with a previously untreated localized HR‐RMS, EES, and UDS were enrolled from Cooperative Weichteilsarkom Studiengruppe (CWS) centers in Germany, Austria, Poland, Switzerland, and from Italian Soft Tissue Sarcoma Committee (STSC) centers. Randomization (1:1) to receive either 9 × 21 days cycles of VAIA or CEVAIE was performed separately in CWS and STSC. Hyperfractionated accelerated radiotherapy (32–44.8 Gy) was added at week 9–12 according to histology and response to chemotherapy. A secondary microscopically complete nonmutilating resection was performed if possible. Primary endpoints were response to chemotherapy, event‐free (EFS) and overall survival (OS). Results: Five hundred fifty‐seven patients (HR‐RMS:n = 416, EES and UDS:n = 141) underwent randomization: VAIA (n = 273) or CEVAIE (n = 284). Radiotherapy was given to 70% of patients in both groups. A secondary resection was performed in 47% and 48% patients, respectively. The 5‐year EFS and OS for the VAIA and CEVAIE treatment arms were 59.8% and 60.8% (p = .89), and 74.2% and 68.3% (p = .16), respectively. No differences in response, toxicity, or second malignancies emerged in the two groups. Conclusion: The use of an intensified regimen failed to show a significant improvement in tumor response and outcome of patients with localized HR‐RMS, EES, and UDS. KW - CEVAIE KW - CWS-96 KW - High-risk soft tissue sarcoma KW - Randomization KW - Rhabdomyosarcoma KW - RMS-96 KW - VAIA PY - 2022 UR - https://nbn-resolving.org/urn:nbn:de:kobv:b43-629373 DO - https://doi.org/10.1002/pbc.29691 SN - 1545-5017 VL - 69 IS - 9 SP - 1 EP - 11 PB - Wiley CY - New York, NY AN - OPUS4-62937 LA - eng AD - Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin, Germany ER -