Chemotherapy for Patients With Newly Diagnosed Very Low-Risk and Low Risk Fusion Negative Rhabdomyosarcoma

To evaluate the failure free survival of patients with very low-risk rhabdomyosarcoma when treated with 24 weeks of vincristine and dactinomycin; To evaluate the failure free survival of patients with low-risk rhabdomyosarcoma when treated with 12 weeks of vincristine, dactinomycin and cyclophosphamide followed by 12 weeks of vincristine and dactinomycin

• Children and Adults 21 years of age or younger
• Must be enrolled on APEC14B and consented to the Molecular Characterization Initiative (Part A)
• Newly diagnosed embryonal rhabdomyosarcoma, spindle cell/sclerosing rhabdomyosarcoma, or FOXO1 fusion negative alveolar rhabdomyosarcoma (institutional FOXO1 fusion results are acceptable)
• For staging, patients will be eligible for the very low-risk stratum (Regimen VA) if they have Stage 1, CG I disease and patients will be eligible for the low-risk stratum (Regimen VAC/VA) if they have Stage 1, CG II disease, Stage 2, CG I or II disease, or Stage 1, CG III (orbit only) disease

• Chemotherapy treatment based on risk level