What is your treatment approach for a pediatric patient with relapsed histiocytic sarcoma, after prior response to a MEK inhibitor and clofarabine?

What is your preferred first line therapy for a patient with relapsed histiocytic sarcoma, after frontline therapy with CHOP or CHOEP?

• Cladribine + high dose cytarabine
• ICE (ifosfamide/carboplatin/etoposide)
• Dose-esclated CHOP + etoposide then ASCT
• Targeted therapy (such as MEKi, BRAFi, NTRKi, etc)
• Immunotherapy
• Transplantation
• Other