Review Article

Targeted Therapy of Ewing's Sarcoma

Table 3

Uncommon (<10%) Grade 3 and 4 toxicities of antiinsulin-like growth factor 1 receptor (IGF1R) antibodies.

Anti-IGF1R antibodyGrade 3 or 4 toxicityReference

R1507Phase I: lymphopenia, thrombocytopenia, adrenal hemorrhage, hyperglycemia, DVT/PE, CVA;phase II: thrombocytopenia, anemia, pain, hyponatremia, hyperglycemia [9, 26]
CP-751,871
(figitumumab)
Fatigue, pain, hyperglycemia, increased LFTs, proteinuria; with mTOR RAD001 (everolimus): nausea, fatigue, diarrhea, hypophosphatemia, mucositis [7, 42]
AMG-479Phase I: thrombocytopenia, hyperglycemia; phase II: thrombocytopenia, anemia, pain, dyspnea, nausea/vomiting, hyperglycemia [8, 27]
SCH-717454
(robatumumab)
Constipation, hyperglycemia, back pain[24]
IMC-A12
(cixutumumab)
With mTOR inhibitor (temsirolimus): hypercholesterolemia, hypertriglyceridemia, hyperglycemia, mucositis (all of these events can be ascribed at least in part to temsirolimus)[28]
MK-0646Thrombocytopenia, skin rash, hyperglycemia, fatigue, GI bleeding, elevated LFTs, respiratory problems[29]

DVT: deep venous thrombosis; PE: pulmonary embolism; CVA: cerebrovascular accident; LFT: liver function test; mTOR: mammalian target of rapamycin; GI: gastrointestinal.
Note: Grade 3 or 4 toxicities have been seen in <10% of patients. These antibodies have generally been very well tolerated with few side effects compared to standard EWS chemotherapy.