How do you treat metastatic epithelioid sarcoma in pediatric patients?

The outcomes for pediatric patients with metastatic epithelioid sarcoma are dismal. Although generally considered chemotherapy and radiotherapy insensitive, consideration could be given for their combined use in a neoadjuvant fashion based on some reported responses that may allow for delayed surgical approaches and/or prolonged disease control. The most "active" regimens appear to be ifosfamide/doxorubicin and gemcitabine/docetaxel. There are two good recent reviews combining cooperative group ...