Evidence for the efficacy of immunotherapy in children with high-risk neuroblastoma

Postepy Hig Med Dosw (Online). 2016 Sep 28;70(0):1001-1004. doi: 10.5604/17322693.1220380.

Abstract

Neuroblastoma is the most common extra-cranial malignancy of childhood, with the highest incidence in children younger than 4 years. The prognosis depends on many factors, such as age at diagnosis, stage of disease and molecular genetic subtype. More than 50% of children who present with the disease are deemed to have high-risk neuroblastoma. The standard therapy for children with high-risk neuroblastoma consists of intensive chemotherapy, surgery, radiotherapy, myeloablative consolidation with autologous haematopoietic stem cell rescue followed by the treatment of minimal residual disease with 13-cis-retinoic acid. Unfortunately, more than half of the patients relapse regardless of the treatment intensity. Combined therapy with monoclonal antibodies (anti-GD2), intravenous interleukin-2 (Il-2), intravenous granulocyte-macrophage colony-stimulating factor (GM-CSF) and oral 13-cis-retinoic acid have been proved to be effective in some randomised trials. A better understanding of the underlying immunological processes in therapy with anti-GD2 antibodies will allow its success to be evaluated more accurately and direct future endeavours. Nevertheless, the long-term benefit of this treatment approach needs to be established.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child
  • Child, Preschool
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use
  • Humans
  • Immunotherapy*
  • Infant
  • Interleukin-2 / therapeutic use
  • Isotretinoin / therapeutic use
  • Neoplasm Recurrence, Local*
  • Neuroblastoma / drug therapy
  • Neuroblastoma / pathology
  • Neuroblastoma / therapy*
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Interleukin-2
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • Isotretinoin