How do you manage newly diagnosed stage IV embryonal rhabdomyosarcoma?
Parameningeal disease with distant metastatic deposits to lymph nodes and lungs, fusion negative. What are the considerations for cyclophosphamide dosing?
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What chemotherapy regimen do you use for stage 4 group IV fusion-negative rhabdomyosarcoma patients not enrolled on a clinical trial?
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2 Answers
Mednet MemberInvited Expert
Pediatric Hematology/Oncology · University of Florida College of Medicine
Answered on
Given stage 4 FOX01- RMS, I think you can either use protocol ARST0431 which has 10.8g/m2 (>4y) or 360 mg/kg (<4y) of CPM, or ARST1431 (8.4g/m2) since cumulative CPM dosing is not that much different. I do not dose modify CPM based on the primary site.
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Mednet MemberInvited Expert
Pediatric Hematology/Oncology · Children's Mercy Hospitals and Clinics
Answered on
In my opinion, stage 4 group IV fusion negative (embryonal) rhabdomyosarcoma is a challenge right now. It is considered intermediate-risk currently but has bounced between high-risk and intermediate-risk on the last couple of protocols. My personal interpretation of the literature is that using VAC/...
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