The Intergroup Rhabdomyosarcoma Study (IRS) is designed to answer important therapeutic, clinical, and laboratory research questions about rhabdomyosarcoma. The IRS has been in existence since 1972 and is a collaborative multidisciplinary study carried out by Children's Cancer Study Group (CCSG) and the Pediatric Oncology Group (POG). Eligible patients in CCSG and POG institutions are registered on the IRS protocols. There have been three protocol studies: IRS-I (1972-78), IRS-II (1978-84), and IRS-III (1984-88, some strata are still open). The fourth protocol, IRS-IV, is in pilot phase (1987- ), and will soon begin. Between 686 and 1002 patients have been entered on each full study (IRS-I,-II,-III). Each protocol beginning with IRS-II developed as an outgrowth of the preceding study. The result of IRS-I,-II,-III have shed light on various surgical, radiotherapeutic and chemotherapeutic aspects of treatment in relation to disease stage, primary tumor site, tumor histology and patterns of disease spread. Patient survival and complete remission (CR) duration have increased progressively and significantly from IRS-I to -II to -III with incremental intensification of therapy to defined risk groups. At 3 years, the overall survival rate of 73% in IRS-III is superior to IRS-II, 67%, and IRS-I, 60% p<.001. The same relationship is true for CR duration (76% vs 69% vs 64%, p<.001). Patient follow-up and data analysis will continue until all patients have been followed for a minimum of 5 years from the start of treatment. Late treatment effects are being monitored and identified in selected patient subgroups. IRS-IV will be activated by late 1989. It will accrue patients over a 4-year period. Pilot studies of the component regimens are in progress. A new IRS-derived TNM pre-treatment staging classification will determine treatment randomization. The main chemotherapy questions are (1) comparison of the efficacy of cyclophosphamide vs ifosfamide vs ifosfamide + VP-16, and (2) rank ordering of induction drug doublets (vincristine/melphalan vs ifosfamide/etoposide vs ifosfamide doxorubicin) and their clinical cross-resistance to VAC therapy. A major radiotherapy question also will be addressed: hyperfractionated dose vs conventional dose. Other studies will include: immunohistochemistry, electron microscopy, cytogenetics, DNA flow cytometry, monoclonal antibody probes, establishment of a tumor cell bank for molecular genetic and other studies of tumor tissue, pilot studies of new therapies, late effects, and epidemiology.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Cooperative Clinical Research--Cooperative Agreements (U10)
Project #
5U10CA024507-14
Application #
3556725
Study Section
Special Emphasis Panel (SRC (B2))
Project Start
1979-01-01
Project End
1994-12-31
Budget Start
1992-01-01
Budget End
1992-12-31
Support Year
14
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Virginia Commonwealth University
Department
Type
Schools of Medicine
DUNS #
City
Richmond
State
VA
Country
United States
Zip Code
23298
Sankaran, Hari; Danysh, Heather E; Scheurer, Michael E et al. (2016) The Role of Childhood Infections and Immunizations on Childhood Rhabdomyosarcoma: A Report From the Children's Oncology Group. Pediatr Blood Cancer 63:1557-62
Lupo, Philip J; Danysh, Heather E; Plon, Sharon E et al. (2015) Family history of cancer and childhood rhabdomyosarcoma: a report from the Children's Oncology Group and the Utah Population Database. Cancer Med 4:781-90
Wolden, Suzanne L; Lyden, Elizabeth R; Arndt, Carola A et al. (2015) Local Control for Intermediate-Risk Rhabdomyosarcoma: Results From D9803 According to Histology, Group, Site, and Size: A Report From the Children's Oncology Group. Int J Radiat Oncol Biol Phys 93:1071-6
Grufferman, Seymour; Lupo, Philip J; Vogel, Rachel Isaksson et al. (2014) Parental military service, agent orange exposure, and the risk of rhabdomyosarcoma in offspring. J Pediatr 165:1216-21
Lupo, Philip J; Zhou, Renke; Skapek, Stephen X et al. (2014) Allergies, atopy, immune-related factors and childhood rhabdomyosarcoma: a report from the Children's Oncology Group. Int J Cancer 134:431-6
Lupo, Philip J; Danysh, Heather E; Skapek, Stephen X et al. (2014) Maternal and birth characteristics and childhood rhabdomyosarcoma: a report from the Children's Oncology Group. Cancer Causes Control 25:905-13
Raney, Beverly; Huh, Winston; Hawkins, Douglas et al. (2013) Outcome of patients with localized orbital sarcoma who relapsed following treatment on Intergroup Rhabdomyosarcoma Study Group (IRSG) Protocols-III and -IV, 1984-1997: a report from the Children's Oncology Group. Pediatr Blood Cancer 60:371-6
Skapek, Stephen X; Anderson, James R; Hill, D Ashley et al. (2013) Safety and efficacy of high-dose tamoxifen and sulindac for desmoid tumor in children: results of a Children's Oncology Group (COG) phase II study. Pediatr Blood Cancer 60:1108-12
Gupta, Abha A; Anderson, James R; Pappo, Alberto S et al. (2012) Patterns of chemotherapy-induced toxicities in younger children and adolescents with rhabdomyosarcoma: a report from the Children's Oncology Group Soft Tissue Sarcoma Committee. Cancer 118:1130-7
Breneman, John; Meza, Jane; Donaldson, Sarah S et al. (2012) Local control with reduced-dose radiotherapy for low-risk rhabdomyosarcoma: a report from the Children's Oncology Group D9602 study. Int J Radiat Oncol Biol Phys 83:720-6

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