GD2-targeted immunotherapy and potential value of circulating microRNAs in neuroblastoma

Neuroblastoma (NB) with various clinical presentation is a known childhood malignancy. Despite significant progress in treatment of NB afflicted patients, high risk disease is usually associated with poor outcome, resulting in long-term survival of less that 50%. Known as a disease most commonly originated form the nerve roots, the variants involved in NB imitation and progression remain to be elucidated. The outcome of low to intermediate risk disease is favorable whereas the high risk NB disease with dismal prognosis, positing the necessity of novel approaches for early detection and prognostication of advanced disease. Tailored immunotherapy approaches have shown significant improvement in high-risk NB patients. It has found a link between Gangliosides and progression of NB. The vast majority of neuroblastoma tumors express elevated levels of GD2, opening new insight into using anti-GD2 drugs as potential treatments for NBs. Implication of anti-GD2 monoclonal antibodies for treatment of high risk NBs triggers further investigation to unearth novel biomarkers as prognostic and response biomarker to guide additional multimodal tailored treatment approaches. A growing body of evidence supports the usefulness of miRNAs to evaluate high risk NBs response to anti-GD2 drugs and further prevent drug-related toxicities in refractory or recurrent NBs. miRNAs and circulating proteins in body fluids (plasma and serum) present as potential biomarkers in early detection of NBs. Here, we summarize various biomarkers involved in diagnosis, prognosis and response to treatment in patients with NB. We further attempted to overview prognostic biomarkers in response to treatment with anti-GD2 drugs. NB is known as a heterogenetic disease in children. In spite of obtaining many achievements in the finding and understanding of molecular pathways and biological heterogeneity of this disease, NB has remained a growing malignancy in children. GD2 ganglioside is known as an agent involved in carcinogenesis and has important biology roles in NB development. Various drugs can block this agent such as anti-GD2 drugs. The recognition of new biomarkers that associated with prognosis, diagnosis, therapy, survival, response to treatment, and relapse after treatment with anti-GD2 drugs treatment may contribute to improve and monitor of disease progression in NB afflicated patients.