Ewing sarcoma – pathomechanisms, standard treatment and new therapeutic perspectives

Introduction: Ewing sarcoma is the second most common bone tumor among children, and due to its high malignancy 5-year survival rate for patients with primary lesions is around 70%. This number drops to merely 30% if metastases are present. Despite combined modality treatment, including radiotherap...

Full description

Saved in:
Bibliographic Details
Main Authors: Wojciech Zezuliński, Filip Woliński, Julia Zyśk, Mateusz Korga, Jakub Klas, Jacek Baj, Eliasz Dzierżyński
Format: Article
Language:English
Published: Nicolaus Copernicus University in Toruń 2025-01-01
Series:Quality in Sport
Subjects:
Online Access:https://apcz.umk.pl/QS/article/view/56905
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1841545224881438720
author Wojciech Zezuliński
Filip Woliński
Julia Zyśk
Mateusz Korga
Jakub Klas
Jacek Baj
Eliasz Dzierżyński
author_facet Wojciech Zezuliński
Filip Woliński
Julia Zyśk
Mateusz Korga
Jakub Klas
Jacek Baj
Eliasz Dzierżyński
author_sort Wojciech Zezuliński
collection DOAJ
description Introduction: Ewing sarcoma is the second most common bone tumor among children, and due to its high malignancy 5-year survival rate for patients with primary lesions is around 70%. This number drops to merely 30% if metastases are present. Despite combined modality treatment, including radiotherapy, surgery, pre- and post-surgery chemotherapy, the mortality of patients is still too high. This shows a great need to look for new therapeutic options.  Methodology: Comprehensive literature review was conducted across databases, including PubMed and Google Scholar for studies published between 2000 and 2023. This review presents factors that play a key role in pathogenesis and are potential points of targeted therapy. The paper discusses, among other things, treatment attempts based on the role of the EWS-FLI1 protein, epigenetics, tyrosine kinase inhibitors, immunotherapies and the use of nanomedicine and viruses, as well as the difficulties associated with their application. Findings: The studies cited vary depending on the phase of the clinical trial they are on, of which teprotumumab, robatumumab, and a combination of cixutumumab/temsyrolimus, ivodesinib, Nivolumab (a PD-1 inhibitor), and Ipilimumab (a CTLA-4 inhibitor) are quite advanced as well as those conducted only on animals and in vitro like YK-4-279 molecule, mithramycin 2'-oxime, NK cells, siRNAs with cationic detonation nanodiamonds (DNDs) and Il-12 by means of lentiviruses. Conclusions: They are new and promising approaches in cases where standard treatments fail, yet they still require further study. Knowledge of the mechanisms of Ewing's sarcoma formation and its metastases, currently accepted treatment standards, critical points in the pathomechanism and current attempts at treating Ewing's sarcoma is essential for choosing the best treatment and effectively reducing its mortality rate.
format Article
id doaj-art-b5be004eb4f94561931b5eea513b0baa
institution Kabale University
issn 2450-3118
language English
publishDate 2025-01-01
publisher Nicolaus Copernicus University in Toruń
record_format Article
series Quality in Sport
spelling doaj-art-b5be004eb4f94561931b5eea513b0baa2025-01-12T08:22:51ZengNicolaus Copernicus University in ToruńQuality in Sport2450-31182025-01-013710.12775/QS.2025.37.56905Ewing sarcoma – pathomechanisms, standard treatment and new therapeutic perspectivesWojciech Zezuliński0https://orcid.org/0009-0005-6395-3217Filip Woliński1https://orcid.org/0000-0002-6444-5645Julia Zyśk2https://orcid.org/0009-0000-4316-4839Mateusz Korga3https://orcid.org/0000-0002-3317-5726Jakub Klas4https://orcid.org/0000-0002-4795-1909Jacek Baj5https://orcid.org/0000-0002-1372-8987Eliasz Dzierżyński6https://orcid.org/0009-0005-4181-7556Student Scientific Club at the Department of Orthopedics and Traumatology Medical University of Lublin Student Scientific Group, Department of Forensic Medicine, Medical University of Lublin, ul. Jaczewskiego 8bMilitary Teaching Hospital with Polyclinic of Independent Public Health Care Unit in Lublin, PolandStudent Scientific Club at the Department of Orthopedics and Traumatology Medical University of LublinStudent Scientific Club at the Department of Radiotherapy, Medical University of LublinDepartment of Human Anatomy, Medical University of Lublin, 20-090 Lublin, Poland. St. John’s Cancer Center, Department of Plastic Surgery, 20-090 Lublin, Poland Introduction: Ewing sarcoma is the second most common bone tumor among children, and due to its high malignancy 5-year survival rate for patients with primary lesions is around 70%. This number drops to merely 30% if metastases are present. Despite combined modality treatment, including radiotherapy, surgery, pre- and post-surgery chemotherapy, the mortality of patients is still too high. This shows a great need to look for new therapeutic options.  Methodology: Comprehensive literature review was conducted across databases, including PubMed and Google Scholar for studies published between 2000 and 2023. This review presents factors that play a key role in pathogenesis and are potential points of targeted therapy. The paper discusses, among other things, treatment attempts based on the role of the EWS-FLI1 protein, epigenetics, tyrosine kinase inhibitors, immunotherapies and the use of nanomedicine and viruses, as well as the difficulties associated with their application. Findings: The studies cited vary depending on the phase of the clinical trial they are on, of which teprotumumab, robatumumab, and a combination of cixutumumab/temsyrolimus, ivodesinib, Nivolumab (a PD-1 inhibitor), and Ipilimumab (a CTLA-4 inhibitor) are quite advanced as well as those conducted only on animals and in vitro like YK-4-279 molecule, mithramycin 2'-oxime, NK cells, siRNAs with cationic detonation nanodiamonds (DNDs) and Il-12 by means of lentiviruses. Conclusions: They are new and promising approaches in cases where standard treatments fail, yet they still require further study. Knowledge of the mechanisms of Ewing's sarcoma formation and its metastases, currently accepted treatment standards, critical points in the pathomechanism and current attempts at treating Ewing's sarcoma is essential for choosing the best treatment and effectively reducing its mortality rate. https://apcz.umk.pl/QS/article/view/56905Ewing sarcomaEWS-FLI1EpigeneticsPathomechanismsMetastasis
spellingShingle Wojciech Zezuliński
Filip Woliński
Julia Zyśk
Mateusz Korga
Jakub Klas
Jacek Baj
Eliasz Dzierżyński
Ewing sarcoma – pathomechanisms, standard treatment and new therapeutic perspectives
Quality in Sport
Ewing sarcoma
EWS-FLI1
Epigenetics
Pathomechanisms
Metastasis
title Ewing sarcoma – pathomechanisms, standard treatment and new therapeutic perspectives
title_full Ewing sarcoma – pathomechanisms, standard treatment and new therapeutic perspectives
title_fullStr Ewing sarcoma – pathomechanisms, standard treatment and new therapeutic perspectives
title_full_unstemmed Ewing sarcoma – pathomechanisms, standard treatment and new therapeutic perspectives
title_short Ewing sarcoma – pathomechanisms, standard treatment and new therapeutic perspectives
title_sort ewing sarcoma pathomechanisms standard treatment and new therapeutic perspectives
topic Ewing sarcoma
EWS-FLI1
Epigenetics
Pathomechanisms
Metastasis
url https://apcz.umk.pl/QS/article/view/56905
work_keys_str_mv AT wojciechzezulinski ewingsarcomapathomechanismsstandardtreatmentandnewtherapeuticperspectives
AT filipwolinski ewingsarcomapathomechanismsstandardtreatmentandnewtherapeuticperspectives
AT juliazysk ewingsarcomapathomechanismsstandardtreatmentandnewtherapeuticperspectives
AT mateuszkorga ewingsarcomapathomechanismsstandardtreatmentandnewtherapeuticperspectives
AT jakubklas ewingsarcomapathomechanismsstandardtreatmentandnewtherapeuticperspectives
AT jacekbaj ewingsarcomapathomechanismsstandardtreatmentandnewtherapeuticperspectives
AT eliaszdzierzynski ewingsarcomapathomechanismsstandardtreatmentandnewtherapeuticperspectives