None — BACKGROUND: Neuroblastoma is a cancerous tumor that develops in the nerve tissue. It most often begins in early childhood. Neuroblastomas are most often found in the adrenal glands connected to the kidneys. But these tumors can also be found in the neck, chest or spinal cord. Neuroblastoma is a very aggressive cancer that often spreads to other areas of the body. There are about 650 new cases of neuroblastoma every year in the United States (Mayo Clinic). Neuroblastoma is classified into three categories; low, intermediate, and high risk. The low risk disease is most commonly found in infants and is easily treated with surgery and observation. Intermediate risk patients can be treated with surgery accompanied by chemotherapy. The high risk disease is very difficult to treat and involves intensive multi-modal therapies.
CURRENT TREATMENTS: Treatment options are based upon several criteria. These include the age of the patient, the extent that the disease has spread, the microscopic appearance of the disease, and the genetic features which classify the disease as low, intermediate or high risk. When the lesion is localized, it can be easily removed with surgery followed by observation to insure no cells have spread. For high risk patients, there are many treatment options, and sometimes more than one of these treatments are used. These aggressive multi-modal therapies include chemotherapy, surgery, radiation, stem cell transplants and immunotherapy. For patients that are of low to intermediate risk, chances of survival are between 70 and 90 percent. High risk patients have about a 30 percent chance of survival after treatment.
NEW TREATMENT: Now researchers are looking at new treatment options for high risk neuroblastoma patients. They are studying a treatment that uses an antibody to trigger the immune system to fight off neuroblastoma cells. A study using 226 high risk patients randomized groups to receive different treatments. One group received a stem cell transplant while the other group received a stem cell transplant accompanied by the ch14.18 antibody. Two years following the treatment, 66 percent of the antibody group was disease free while only 46 percent of the stem cell transplant group was alive and disease free. This antibody therapy will also include two cytokines, which are hormones that amplify the effects of the immune system. This treatment is still in the experimental stages, but it is the first treatment in more than ten years that provides a substantial cure rate for high risk patients.