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ArticleOncology and therapy2026

Multimodal Combination Treatment in a Patient-Centered Approach is Associated with Improved Outcome in Relapsed/Refractory Sarcomas in Children: A Comparative Single-Institution Real-World Analysis.

Michal Kyr, Kristyna Polaskova, Peter Mudry, Vitezslav Dusek, Klara Vejmelkova, Zuzana Kuttnerova, Pavel Tinka, Tomas Merta, Petra Pokorna, Hana Palova and 6 more

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Article in Oncology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Michal Kyr *Department of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic. 5468@fnbrno.cz.ORCID http://orcid.org/0000-0001-6623-8386
Kristyna Polaskova *Department of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic.
Peter MudryDepartment of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic.
Vitezslav DusekDepartment of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic.
Klara VejmelkovaDepartment of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic.
Zuzana KuttnerovaDepartment of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic.
Pavel TinkaDepartment of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic.
Tomas MertaDepartment of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic.
Petra PokornaDepartment of Biology, Faculty of Medicine and Central, European Institute of Technology, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
Hana PalovaDepartment of Biology, Faculty of Medicine and Central, European Institute of Technology, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
Jakub NeradilDepartment of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic.
Renata VeselskaDepartment of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic.
Marta JezovaDepartment of Pathology, Faculty of Medicine, University Hospital Brno, Masaryk University, Jihlavská 25, 625 00, Brno, Czech Republic.
Ondrej SlabyDepartment of Biology, Faculty of Medicine and Central, European Institute of Technology, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
Dalibor ValikDepartment of Pharmacology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
Jaroslav SterbaDepartment of Pediatric Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Černopolní 9, 61300, Brno, Czech Republic.

Funding

HORIZON EUROPE Widening participation and spreading excellence 101059788Ministerstvo Školství, Mládeže a Tělovýchovy LM2023049Ministerstvo Školství, Mládeže a Tělovýchovy LX22NPO5102Ministerstvo Školství, Mládeže a Tělovýchovy MUNI/A/1764/2024Ministerstvo Zdravotnictví Ceské Republiky 65269705Ministerstvo Zdravotnictví Ceské Republiky FNBrMinisterstvo Zdravotnictví Ceské Republiky NU20-03-00240Ministerstvo Zdravotnictví Ceské Republiky NV16-34083AMinisterstvo Zdravotnictví Ceské Republiky NV19-03-00562Nadacní Fond Detské Onkologie Krtek COEF
6 · The paper itself

Abstract

introductionTargeted treatment in children, especially with sarcomas, has limited utility due to small numbers of patients with driving mutations. Multimodal combination treatment and patient-centered approach combine treatment modalities administered based on comprehensive biological and empirical factors. Together, they extend precision oncology beyond a single molecular target.

methodsThis is a single-institution real-world study of children and young adults diagnosed between 2004 and 2021, with relapsed/refractory and/or primary metastasizing high-risk solid tumors who underwent molecular tumor board. Patients underwent comprehensive biological examination of the tumor. A treatment recommendation was made subsequently combining empirical and biological data. All progressive/recurrent events during disease follow-up were analyzed using a hierarchical survival modeling approach combining individual patient time series in a meta-analytic framework for comparative analysis of treatment effects.

resultsA total of 93 patients were included in the analysis who experienced 189 events. Overall survival was 7.5 years. A comparative analysis utilizing event-free survival (EFS) ratio was possible in an ultra-high-risk subset of 66 patients with relapsed/progressive disease. Effectiveness was demonstrated in the treatment of sarcomas by empirical treatment (HR 0.57, p = 0.005), which consisted mainly of orally administered cyclophosphamide, vinblastine, and celecoxib, and by sunitinib or pazopanib (HR = 0.66, p = 0.032) in biologically guided administration.

conclusionsThis study demonstrates that individualized treatment offers effective treatment options to a wide range of patients with high-risk cancers even for tumors without known high-level evidence molecular targets. We have shown that an alternative analytical approach based on the n-of-1-inspired framework is needed and applicable to demonstrate the effectiveness.

Indexed as

Metronomic chemotherapyN-of-1Personalized oncologyRare cancerTargeted treatment

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.