Metastatic Ewing's Trial Testing Schedule Enhancement to Improve Outcomes

Prior treatment

• Patients who are receiving any other investigational agents for their cancer.
• Patients must not be receiving any additional medicines being given for the specific purpose of treating cancer.

Other illness

• Patients with localized disease or lung only metastases for Ewing sarcoma or localized disease for CIC-rearranged sarcomas.
• Patients with a history of cancer that was treated with myelosuppressive chemotherapy or radiation therapy.
• Patients are ineligible if they have uncontrolled intercurrent illness.

Lab values

• Pregnancy or Breast Feeding: Pregnant or breast-feeding women will not be entered on this study, because there is no available information regarding human fetal or teratogenic toxicities. Females of childbearing potential must have a negative serum or urine pregnancy test within 72 hours prior to starting protocol therapy.

Other

• Patients with central nervous system (CNS) tumors (primary or metastatic) are not eligible.
• Patients who are considered unable to comply with the safety monitoring requirements of the study are not eligible.

• Patients must be \>1 year of age. There is no upper age limit.
• Patients, in the opinion of the enrolling investigator, must be healthy enough to tolerate protocol therapy.
• Patients must have a new histologic diagnosis of either: widely metastatic Ewing sarcoma or metastatic CIC-rearranged sarcoma.
• Patients must have sufficient tissue submitted (flash frozen tissue, FFPE block, or up to 10 unstained FFPE slides) for correlative testing. This may be from a primary or metastatic site.
• Patients must not have received any prior systemic therapy with the exception that they may have started an initial cycle of vincristine/doxorubicin/cyclophosphamide (VDC) prior to enrollment, i.e. VDC may have been given, but not ifosfamide/etoposide (IE).
• Adequate organ function.
• Males and females of reproductive potential may not participate unless they have agreed to the use of, at minimum, two methods of contraception during and after treatment or abstinence.
• All patients and/or their parents or legal guardians must have the ability to understand and the willingness to sign a written informed consent or assent document.