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Diagnosed with PNET-ewings sarcoma. What treatment should be done?

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Practicing since : 2002
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My queirey is particularly for Dr XXXXXX Oncologist from USA.,my neice XXXXXX 13yrs female was diagnoised with PNET-ewings sarcoma in XXXXXX 2011.details have been given in medical history.and also we have attached her reports along with the pet kindly gives the best options available to treat her.she is physically fit and going to school daily.she can travell any where presently and we are ready to go any extent to treat her.currently she is on her first cycle of salvage chemotherapy(details in the medical history column).
Posted Fri, 19 Oct 2012 in Cancer
Answered by Dr. Robert Galamaga 7 hours later
Hello and thank you for sending your question.

Your question is a very good one and a very difficult one. I will do my best here to provide you with some information and recommendations.

I have reviewed all of the reports and imaging studies which you have submitted. As you know this is an extremely difficult cancer to treat in the metastatic setting.

Your daughter has an doored many toxicchemotherapy regimens and at this point careful consideration must be made regarding additional treatmentas we must consider the toxicity of therapy compared to the possible benefits.

At this point she has received standard chemotherapy treatment that would be regarded as optimal for her situation.

Generally at this point when a patient remains refracture he to treatment there are a couple of considerations.

One consideration would be for a referral for high-dose chemotherapy followed by a stem cell transplant. This would be a very aggressive and toxic treatment with a possible benefit of Keuer although that is extremely rare.

The other consideration which might be considered would be participation in a clinical trial. Clinical trials will offer you access to medications which have not been approved for routine use.

Generally clinical trials are reserved for patients who do not respond to available treatment regimens.

One medication which is in clinical trial in the United States is yondelis. This medication has shown activity in certain types of sarcoma.

This is just one consideration. There maybe other clinical trials available but it really depends on your location and your ability to travel.

If you are willing to travel you might consider going to a large cancer center such as Mayo Clinic located in the United States in the state of Minnesota. They may have some clinical trials which may be available for your daughter.

Thank you again for sending your question. I'm sure this is a very stressful situation and You are dealing with a great deal of anxiety.

If you have any additional concerns or questions I would be happy to review those with you.


Dr. Robert
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