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Miscellaneous: Bone sarcoma: Ewing chemotherapy (Euro Ewing 2012)

Free question published 14 October 2026

MiscellaneousBone sarcoma: Ewing chemotherapy (Euro Ewing 2012)

A 17-year-old presents with a localised Ewing sarcoma of the pelvis and is referred to a specialist bone sarcoma centre. The oncologist plans multimodality treatment with neoadjuvant chemotherapy, local control and adjuvant chemotherapy. Which induction chemotherapy regimen is associated with superior event-free and overall survival for newly diagnosed Ewing sarcoma?

  1. AGemcitabine and docetaxel
  2. BVincristine, doxorubicin and cyclophosphamide with ifosfamide and etoposide (VDC/IE) induction
  3. CCisplatin, doxorubicin and high-dose methotrexate (MAP)
  4. DVincristine, ifosfamide, doxorubicin and etoposide (VIDE) as the induction chemotherapy regimen for Ewing sarcoma
  5. ESingle-agent doxorubicin

Why B is correct

Euro Ewing 2012 (EE2012) compared the European VIDE-based induction against the interval-compressed US-style VDC/IE regimen in newly diagnosed Ewing sarcoma. VDC/IE (vincristine, doxorubicin and cyclophosphamide alternating with ifosfamide and etoposide) gave superior event-free and overall survival, with 3-year overall survival of 82% versus 74% for VIDE, establishing VDC/IE as the preferred induction.

And why the others are not

  • AGemcitabine and docetaxel is a salvage regimen for relapsed sarcoma, not first-line Ewing induction.
  • CMAP is the standard regimen for osteosarcoma, not Ewing sarcoma.
  • DVIDE was the comparator arm and was inferior to VDC/IE for event-free and overall survival in EE2012.
  • ESingle-agent doxorubicin is inadequate; Ewing sarcoma requires multi-agent intensive chemotherapy.

Source Euro Ewing 2012 (EE2012) - VIDE versus VDC/IE chemotherapy for newly diagnosed Ewing sarcoma — Brennan B, Kirton L, Marec-Berard P, et al. Comparison of two chemotherapy regimens in patients with newly diagnosed Ewing sarcoma (EE2012): an open-label, randomised, phase 3 trial. Lancet. 2022;400(10362):1513-1521.

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