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Ewing Sarcoma Treatment

Ewing sarcoma is a cancerous tumor. It starts in the bone, often the leg, pelvis, ribs, arm, or spine. In about 1/3 of patients with Ewing sarcoma, the cancer has already spread to the lungs, lymph nodes, bones, or bone marrow by the time it is diagnosed. Ewing sarcoma can grow in the tissue around the bones (the soft tissue). But this is rare.

Ewing sarcoma is the second most common type of bone cancer in children. Of those with Ewing sarcoma:

  • About 50% (1 in 2) of all Ewing sarcoma tumors are in children and young adults ages 10–20.
  • It affects slightly more boys than girls.
  • It is rarely found in African Americans and Asian Americans.
  • It does not seem to be inherited (passed down in families).
  • Ewing sarcoma can occur as a second cancer, especially in patients treated with radiation therapy. But this is uncommon.

Learn more about Ewing sarcoma on the Together by St. Jude™ online resource.

Treatment of Ewing sarcoma

Your child’s care team will likely use several things to treat Ewing sarcoma:

  • Chemotherapy ("chemo") to kill cancer cells or stop them from growing (dividing) and making more cancer cells.
  • Surgery to remove as much of the tumor as possible
    • Sometimes surgeons will graft (add on) bone or tissue. These grafts replace diseased bone and tissue that have been removed.
    • An artificial bone, called an implant, may also be used.
    • Limb-sparing surgery may be used. During this surgery, the bone is replaced with a prosthesis.
    • For some patients, amputation (the surgical removal of an arm or leg) is needed. This makes sure the tumor is completely removed.
  • Radiation therapy to kill or decrease cancer cells that cannot be removed surgically. This therapy is usually followed by more chemo to kill any remaining cells.

Ewing sarcoma clinical trials

St. Jude offers clinical trials and cancer research studies for children, teens, and young adults with Ewing sarcoma and other solid tumors. Learn more about clinical research at St. Jude.

ONITT: Study of Onivyde with Talazoparib or Temozolomide in Children and Young Adults with Recurrent/Refractory Solid Tumors and Ewing Sarcoma

Study goal:

The main goal of this study is to test new experimental drugs in hopes of finding a treatment that may work against tumors that have come back or that have not responded to standard therapy in children, adolescents and young adults.


12 months to 30 years old

3CAR: B7-H3-specific CAR T-cell Therapy for Children and Young Adults with Solid Tumors

Study goal:

The main purpose of 3CAR is to find out if this type of immunotherapy is safe for pediatric patients with solid tumors. We also want to learn if it is effective in fighting solid tumors.


Up to 21 years old

PEPN2011: Tegavivint Treatment for Solid Tumors, Lymphomas, and Desmoid Tumors

Study goal:

The main purpose of this study is to find out how well the medicine tegavivint works to help children, teens, and young adults with certain recurrent or refractory solid tumors.


12 months to 30 years

PAINBDY1: Treating Pain in Children with Cancer: Pain Buddy

Study goal:

The main goal of this research study is to help us learn how to better treat pain and symptoms in children going through chemotherapy cancer treatment.


8 to 18 years old

Ewing sarcoma care at St. Jude

St. Jude provides the highest quality of care for patients with Ewing sarcoma:

  • St. Jude researchers identified important drug combinations that target the Ewing sarcoma tumor cell’s inability to repair DNA. If the tumor cell cannot repair DNA, then it dies. These treatments, administered on a trial called BMNIRN, were evaluated in patients with relapsed Ewing sarcoma. We found that some patients with relapsed Ewing sarcoma respond to therapy.
  • St. Jude researchers are conducting a clinical trial called ONITT that targets the Ewing sarcoma cell’s vulnerability. ONITT is a phase 1 / 2 study of Onivyde along  with talazoparib or temozolomide in children and young adults with recurrent or refractory solid tumors and Ewing sarcoma. The ONITT study is an international St. Jude–led study that is open at different sites across North America.
  • Radiation treatments, such as intensity-modulated radiation therapy (IMRT) and proton beam radiation therapy, deliver focused radiation to the tumor. They also limit the amount of radiation to normal surrounding tissues. This decreases the side effects related to radiation treatment.
  • St. Jude has a team of experts who pioneered limb-salvage procedures (surgery) in children with bone tumors, such as Ewing sarcoma. Limb salvage surgeries allow the surgeon to remove the disease in the bone and replace the bone with a prosthesis. This procedure allows the patient to keep the rest of their limb (leg or arm).
  • Imaging techniques allow St. Jude to better define the effects of treatment in children with Ewing sarcoma. These techniques include contrast-enhanced ultrasound and diffuse weighted imaging MRI.

More reasons to choose St. Jude for care include:

  • We are consistently ranked among the best childhood cancer centers in the nation by US News & World Report. 
  • At St. Jude, we have created an environment where children can be children and families can be together. 
  • We lead more clinical trials for childhood cancer than any other hospital in the U.S. 
  • St. Jude is the only National Cancer Institute–designated Comprehensive Cancer Center just for children. A Comprehensive Cancer Center meets rigorous standards for research that develops new and better approaches to prevent, diagnose, and treat cancer. 
  • The nurse-to-patient ratio at St. Jude is unmatched. It is about 1:3 in hematology and oncology and 1:1 in the Intensive Care Unit. 
  • Patients may be able to get expert, compassionate care and treatment closer to their homes through the St. Jude Affiliate Program.
A statue of children running and holding hands

Seeking treatment at St. Jude

Patients accepted to St. Jude must have a disease we treat and must be referred by a physician or other qualified medical professional. We accept most patients based on their ability to enroll in an open clinical trial.

How to seek treatment

Contact the Physician / Patient Referral Office

Call: 1-888-226-4343 (toll-free) or 901-595-4055 (local)  | Fax: 901-595-4011 | Email: | 24-hour pager: 1-800-349-4334

The solid tumor coordinator is dedicated to helping you seek treatment or refer a patient.

Solid Tumor Coordinator


Learn more