ifosfamide

RA co-treatment (50 mg/kg) significantly reversed all functional, biochemical, and histological damage by strategically breaking this crosstalk, restoring redox homeostasis, and simultaneously restraining both cell death programs. In conclusion, RA protects against IFA nephrotoxicity by targeting the critical inflammation-ferroptosis coupling, positioning it as a highly promising adjuvant candidate for clinical use to mitigate IFA-induced renal injury.

The patient was referred to a sarcoma center where he was started on systemic chemotherapy with a VAC/IE (vincristine, doxorubicin, cyclophosphamide/ifosfamide, etoposide) regimen. CONCLUSIONS This case highlights the diagnostic complexity of DSRCT, particularly in atypical liver-dominant presentations, and reinforces the importance of comprehensive tissue sampling and molecular confirmation to guide early, appropriate therapy. Continued research into targeted strategies is crucial to improve outcomes in this aggressive malignancy.

In particular, pharmacogenetic markers for the following drugs were analyzed: anthracyclines (doxorubicin, daunorubicin), vincristine, glucocorticoids (prednisone, dexamethasone), L-asparaginase, methotrexate, alkylating agents (cyclophosphamide, ifosfamide), 6-mercaptopurine, cytarabine, and etoposide. At present, only a few genes, TPMT and NUDT15, have well-established clinical utility, whereas the clinical relevance of pharmacogenetic markers for other drugs used in pediatric ALL therapy remains under investigation. The review also highlights the main knowledge gaps in current research and outlines promising directions for future studies aimed at integrating pharmacogenetic testing into clinical practice for personalized treatment of ALL.

P2/3, N=140, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Dec 2025 --> Dec 2026

The patient initially presented with a destructive iliac mass in 2021 and underwent induction with doxorubicin/cisplatin, which was complicated by acute kidney injury and thromboembolic events, followed by hemipelvectomy...Treatment with high-dose ifosfamide provided no durable disease control, and imaging demonstrated progressive growth...Resection in June 2022 demonstrated no viable tumor, consistent with complete pathologic response. The patient has since completed one year of adjuvant pembrolizumab, with ongoing therapy and no evidence of recurrence at 24 month follow-up.

P=N/A, N=20, Recruiting, M.D. Anderson Cancer Center | Trial completion date: Dec 2025 --> Dec 2028 | Trial primary completion date: Dec 2025 --> Dec 2028

P2/3, N=437, Active, not recruiting, Children's Oncology Group | Trial completion date: Jul 2032 --> Dec 2027 | Trial primary completion date: Jul 2032 --> Dec 2027

P2, N=80, Recruiting, Mayo Clinic | Trial completion date: Nov 2033 --> Mar 2027 | Trial primary completion date: Feb 2031 --> Mar 2027

This multicentre study confirms that anthracycline-based regimens show activity in MCS, with responses more in line with soft tissue sarcoma than Ewing sarcoma. Their benefit in localized disease remains uncertain, but (neo)adjuvant chemotherapy with Ewing-like regimens should be considered for patients eligible for surgery. In advanced disease, trabectedin may provide prolonged disease control after anthracyclines.

P1, N=6, Active, not recruiting, Washington University School of Medicine | Phase classification: P1/2 --> P1 | N=35 --> 6 | Trial completion date: Jan 2029 --> Mar 2028 | Trial primary completion date: Jan 2027 --> Mar 2026 | Recruiting --> Active, not recruiting

P1/2, N=65, Recruiting, Hoffmann-La Roche | Trial completion date: Sep 2029 --> Nov 2032 | Trial primary completion date: May 2029 --> Nov 2029

The most promising salvage options for patients responding insufficiently to treatment are the chemotherapy combinations, topotecan/vincristine/doxorubicin (TVD), topotecan/cyclophosphamide/etoposide (TCE), ifosfamide/carboplatin/etoposide (ICE) or topotecan/cyclophosphamide (TopoCy), or [131I]-mIBG therapy. Early-phase clinical trials are also a possible option in this setting.