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Aditi Dhir, MD, discusses modifying treatment for adults versus pediatric patients with epithelioid sarcoma.
Aditi Dhir, MD, clinical assistant professor, Department of Pediatrics, Division of Hematology/Oncology, Sylvester Comprehensive Center, University of Miami Health System, discusses modifying treatment for adults versus pediatric patients with epithelioid sarcoma.
Although no head-to-head comparisons of treatment options between adults and pediatric patients exist, there are subtle differences in dosing, as well as preferred regimens between these populations, Dhir explains. Often, treatment selection is driven by tolerance and potential toxicities.
For example, the frontline combination of gemcitabine and docetaxel is preferred for adult patients, whereas pediatric patients are more likely to receive ifosfamide plus doxorubicin, says Dhir. Notably, some regimens, such as radiation therapy, may lead to long-term toxicities, including risk of secondary malignancy or neurocognitive decline. As such, these potential toxicities limit or prohibit the use of high-dose radiation therapy among pediatric patients, explains Dhir. Conversely, adult patients with baseline comorbidities often cannot tolerate very high-dose chemotherapy that is given to pediatric patients, concludes Dhir.