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RecruitingLast updated: 11 June 2026

rEEcur: Comparing four widely used chemotherapy regimens for patients with primary refractory and recurrent Ewing SarcomaInternational Randomised Controlled Trial of Chemotherapy for the Treatment of Recurrent and Primary Refractory Ewing Sarcoma

Trial purpose

Medical clipboardCancer treatment

Tumor type

Sarcoma Cancers Sarcoma

Age

People4 - 50

Trial acronym

rEEcur

Clinical summary

Summary

The purpose of this study is to determine which of the most common chemotherapies used to treat recurrent or primary refractory Ewing Sarcoma is most beneficial.

Who is it for?
People may be eligible for this study if they are aged 2 years or above and have been diagnosed with relapsed or refractory Ewing Sarcoma.

Study details
Participants in this trial will be randomly allocated (by chance) to one of the available treatment groups.

Before treatment starts, the following routine tests will be performed:

  • Physical check-up, including measuring height and weight
  • Blood tests, and possibly urine tests
  • Assessment of kidney function called a GFR
  • Scans (which may include CT, PET-CT, MRI, bone scan, X-ray). The doctor will decide which type of scans are needed depending on where the tumour is located.
  • A quality of life questionnaire will also be completed before treatment commences.

During trial treatment

While participants are having chemotherapy treatment, they will be carefully monitored using the same routine tests that would be used if they were having chemotherapy but were not in the trial. These routine tests will include blood and urine tests, scans and GFR. These tests are to ensure people are fit to continue chemotherapy. In addition, if someone has had a PET-CT scan before treatment, they will have another PET-CT scan after 4 cycles of chemotherapy.

Participants will be asked to complete two more quality of life questionnaires, one on completion of cycle 2 and one on completion of cycle 4.

All treatments in this study are those which are currently used routinely for treatment of Ewing sarcoma.

It is hoped that this research will help to determine which of the treatments is most effective in improving overall survival, side effects, tumour shrinkage, quality of life and days spent in hospital. 

 

Conditions

This trial is treating people with Ewing Sarcoma

Eligibility

Inclusion

1. Histologically confirmed Ewing or Ewing-like sarcoma of the bone or soft tissues. Histological confirmation either at initial diagnosis or disease progression.
2. Radiological evidence of disease progression during or after completion of first or any subsequent line of treatment.
3. Age greater than or equal to 2 years.
4. Eligible for randomisation between at least two open study arms.
5. Patient assessed as medically fit to receive trial treatment
6. Date of planned randomisation within 4 weeks of baseline imaging.
7. Documented negative pregnancy test for female patients of childbearing potential.
8. Patient agrees to use effective contraception during therapy and for 12 months after last trial treatment, where applicable.
9. Written informed consent from the patient and/or parent/legal guardian.
10. Adequate GFR

IFOS-Lenvatinib specific principal inclusion criteria:
1. Adequate liver function
2. Left ventricular ejection fraction greater than or equal to 50% at baseline as determined by echocardiography.
3. Normal or adequately controlled blood pressure (BP)

 

Exclusion

1. Absolute Neutrophil Count (ANC) <1.0 x 10^9/L or platelets <75 x 10^9/L.
2. Cytotoxic chemotherapy or other investigational medicinal product (IMP) within previous two weeks.
3. Myeloablative therapy within previous eight weeks.
4. Radiotherapy to target lesion within previous six weeks.
5. Pregnant or breastfeeding women.
6. Follow-up not possible due to social, geographic or psychological reasons.
7. Previous randomisation into the rEECur trial

IFOS-Lenvatinib specific principal exclusion criteria:
1. Significant proteinuria
2. Arterial Thromboembolism in previous 6 months
3. Gastrointestinal bleeding or active haemoptysis within previous 3 weeks
4. Major surgery within previous 3 weeks
5. Previous treatment with tyrosine kinase inhibitors

 

Inclusion

  • You have had treatment, but your cancer has come back (relapsed or recurrent).
  • You have had treatment but your cancer has gotten worse or has not responded to the treatment you have been given.

Exclusion

  • You are currently being treated on a clinical trial.
  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
Message

Clinical trials have complex eligibility criteria, and other criteria may apply for this trial. Ask your doctor about whether this trial could be right for you.

Participating hospitals

Recruiting hospitals

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More information

Trial Identifiers

Information on this page is partially produced from ANZCTR, UK’s Clinical Study Registry, EU Clinical Trials Register *. View further details about this trial on the registry via the links below:

Trial sponsor

University of Birmingham

Scientific Title

International Randomised Controlled Trial of Chemotherapy for the Treatment of Recurrent and Primary Refractory Ewing Sarcoma

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