CASE REPORT article
Front. Oncol.
Sec. Cancer Molecular Targets and Therapeutics
Case Report: Should IGF-1R Targeted Therapy Be Revisited in Ewing Sarcoma? A Report of Long-term Complete Response and Review of the Literature
Provisionally accepted
Georgios M Stergiopoulos1
Brittany L Siontis1
Safia Ahmed2
Judith Jebastin Thangaiah1Matthew T Houdek1Thanh P Ho1
Scott H Okuno1
Steven I Robinson1*- 1Mayo Clinic, Rochester, United States
- 2Mayo Clinic Arizona, Scottsdale, United States
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Introduction: Ewing sarcoma (ES) is a malignancy that mostly affects adolescents and young adults, with relapse or refractory cases posing major therapeutic challenges. Its unique transcriptional profile offers multiple targetable pathways, including the insulin-like growth factor-1 (IGF-1) receptor (IGF-1R) pathway. Case Report: We present the case of a 42-year-old female with recurrent ES with pulmonary metastases who, after progressing on anti-IGF-1R monotherapy with figitumumab (CP-751,871, NCT00560235), achieved complete remission in a phase I clinical trial (NCT00976508) that combined figitumumab IGF-1R-inhibition with growth hormone receptor antagonist pegvisomant. The patient has remained in long-term remission (>10 years) since the discontinuation of both agents and has not received any additional therapeutic interventions. Literature Review: We reviewed PubMed and the ClinicalTrials.gov database to identify clinical trials employing IGF-1R-targeted therapies in patients with ES and identified 24 relevant studies treating 723 patients with anti-IGF-1R therapy. Conclusion: This case represents the first report to our knowledge of patient outcomes following IGF-1R and growth hormone inhibition combination. The impressive response observed highlights the clinical synergy of this combination which warrants further clinical exploration as well as the potential of IGF-1R inhibition for ES. Additionally, this case suggests that targeted therapy discontinuation might be an option for select patients with long-term complete remission. Keywords: Case Report, Ewing, IGF-1R, Figitumumab, Pegvisomant
Keywords: case report, Ewing, IGF-1R, figitumumab, pegvisomant
Received: 16 Jul 2025; Accepted: 04 Nov 2025.
Copyright: © 2025 Stergiopoulos, Siontis, Ahmed, Jebastin Thangaiah, Houdek, Ho, Okuno and Robinson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Steven I Robinson, robinson.steven@mayo.edu
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