New Therapy Boosts Neuroblastoma Two-Year Cure Rate
Published on in CHOP News
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Published on in CHOP News
May 24, 2011 — Using immunotherapy — biologic agents that stimulate the body’s immune system — pediatric oncologists have achieved the first substantial increase in cure rates for the childhood cancer neuroblastoma in more than a decade. A newly released study shows that the new treatment improved two-year survival rates by 20 percentage points, compared to standard treatment for an aggressive form of neuroblastoma, a cancer of the nervous system.
The study appears in the Sept. 30 issue of the New England Journal of Medicine, along with a separate COG study on intermediate-risk neuroblastoma. The corresponding author of the immunotherapy study is Alice L. Yu, MD, PhD, of the University of California, San Diego.
“We expect these findings will change clinical practice, setting a new gold standard of treatment for this often-deadly disease,” said John M. Maris, MD, a co-author of the study and director of the Center for Childhood Cancer Research at The Children’s Hospital of Philadelphia. Maris is the chair of the neuroblastoma committee of the Children’s Oncology Group (COG), the cooperative multicenter research organization that sponsored the study.
Neuroblastoma, a cancer of the peripheral nervous system, usually appears as a solid tumor in the chest or abdomen. It accounts for 7 percent of all childhood cancers, but because it frequently occurs in an aggressive form, it causes 15 percent of all childhood cancer deaths. While low-risk forms of neuroblastoma may spontaneously disappear, in high-risk forms, the cancer tends to return after initial treatment, usually with lethal results.
In the current study, researchers assigned 226 high-risk patients at multiple cancer centers to receive one of two treatments:
Immunotherapy consisted of:
Monoclonal antibodies are molecular “guided missiles” engineered to kill cancer cells by targeting a substance appearing on those cells. Cytokines are naturally occurring signaling proteins that regulate immune responses.
The Cancer Center at The Children’s Hospital of Philadelphia has been using this immunotherapy regimen as part of standard treatment for children with high-risk neuroblastoma for more than a year, since preliminary trial results were reported in June 2009. Children have arrived from around the world to receive this treatment at Children’s Hospital, which has a long-established research and clinical program in neuroblastoma.
Dr. Maris is internationally prominent as a neuroblastoma expert. Some highlights of his neuroblastoma research efforts include:
“Together, these studies report important advances in care for children with this challenging cancer,” said Maris. “We will continue to investigate treatments to further refine the standard of care.”
This study, Outcome after Reduced Chemotherapy for Intermediate Risk Neuroblastoma, found that physicians could substantially reduce the dose and duration of chemotherapy used for neuroblastoma and still achieve very high survival rates of 98 percent among children receiving the treatment. The benefits of lower doses include:
The corresponding author of this study was Katherine K. Matthay, MD, of the University of California, San Francisco.
Grants from the National Institutes of Health and the Food and Drug Administration supported the immunotherapy study. Grants from the National Cancer Institute, part of the National Institutes of Health, supported the study of intermediate-risk neuroblastoma. Both studies were conducted through the Children’s Oncology Group.