Journal
ONCOTARGET
Volume 8, Issue 56, Pages 95293-95302Publisher
IMPACT JOURNALS LLC
DOI: 10.18632/oncotarget.20513
Keywords
neuroblastoma; anti-G(D2) antibody; autologous transplantation; cytokine; MYCN amplification
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Funding
- National Institutes of Health, Bethesda, MD [CA106450]
- Robert Steel Foundation, New York, NY
- Katie's Find A Cure Fund, New York, NY
- Arnold J. Jacobs Pediatric Cancer Fund, New York, NY
- [P30 CA008748]
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High-risk neuroblastoma (HR-NB) includes MYCN-amplified stage 2/3, but reports covering anti-G(D2) immunotherapy, which recently became standard for HR-NB, do not provide details on this subset. We now report on all 20 MYCN-amplified stage 2/3 patients who received induction chemotherapy at our center during the era of consolidation with anti-G(D2) antibody 3F8/granulocyte-macrophage colony-stimulating factor (GM-CSF) (2000-2015). Early in this period, consolidation included autologous stem-cell transplantation (ASCT). Event-free survival (EFS) and overall survival (OS) were estimated using Kaplan-Meier analyses. With induction, 19/20 (95%) patients achieved complete/very good partial remission (CR/VGPR) but one had progressive disease with early death. One responder did not receive consolidation and died of relapse. Five-year post-diagnosis EFS/OS rates for all 20 patients were 72%/84%. The 18 CR/VGPR patients who received consolidation had EFS/OS 81%/94% at five years from starting 3F8/GM-CSF: 4/4 ASCT patients remained relapse-free, while 11/14 non-ASCT patients remained relapse-free and two of the three relapsed patients achieved 2nd CR (consolidated by retreatment with 3F8/GM-CSF) and remained in 2nd CR at 36+ and 95+ months post-relapse. The 14 non-ASCT patients had EFS/OS 73.5%/93% at five years from starting 3F8/GM-CSF. This subset appears to have a good prognosis with contemporary multi-modality therapy, possibly even without ASCT.
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