Medication Exposures and Subsequent Development of Ewing Sarcoma: A Review of FDA Adverse Event Reports.

Judith U Cope,Gregory H Reaman,Joseph M Tonning

doi:10.1155/2015/948159

Abstract

Background. Ewing sarcoma family of tumors (ESFT) are rare but deadly cancers of unknown etiology. Few risk factors have been identified. This study was undertaken to ascertain any possible association between exposure to therapeutic drugs and ESFT. Methods. This is a retrospective, descriptive study. A query of the FDA Adverse Event Reporting System (FAERS) was conducted for all reports of ESFT, January 1, 1998, through December 31, 2013. Report narratives were individually reviewed for patient characteristics, underlying conditions and drug exposures. Results. Over 16 years, 134 ESFT reports were identified, including 25 cases of ESFT following therapeutic drugs and biologics including immunosuppressive agents and hormones. Many cases were confounded by concomitant medications and other therapies. Conclusions. This study provides a closer look at medication use and underlying disorders in patients who later developed ESFT. While this study was not designed to demonstrate any clear causative association between ESFT and prior use of a single product or drug class, many drugs were used to treat immune-related disease and growth or hormonal disturbances. Further studies may be warranted to better understand possible immune or neuroendocrine abnormalities or exposure to specific classes of drugs that may predispose to the later development of ESFT.

Highlights

Introduction and Study ObjectiveEwing sarcoma family of tumors (ESFT) is a group of small, round blue cell tumors that arise in the bone or soft tissue
After clinical review of the narrative reports 25 cases were identified with a history of medication use prior to ESFT diagnosis, most with a history of ≥18 months
ESFT is known for its striking unimodal incident peak during puberty and few risk factors have been identified as to its etiology

Summary

Introduction

Ewing sarcoma family of tumors (ESFT) is a group of small, round blue cell tumors that arise in the bone or soft tissue. While ESFT is rare, it is the second most common primary malignant bone tumor occurring in children and young adults and accounts for 10–15% of all primary bone tumors and 3% of all pediatric malignancies. This study was undertaken to ascertain any possible association between exposure to therapeutic drugs and ESFT. Over 16 years, 134 ESFT reports were identified, including 25 cases of ESFT following therapeutic drugs and biologics including immunosuppressive agents and hormones. This study provides a closer look at medication use and underlying disorders in patients who later developed ESFT.

Objectives

Methods

Discussion

Conclusion