Curability of recurrent disseminated disease after surgery alone for local-regional neuroblastoma using intensive chemotherapy and anti-GD2 immunotherapy Journal Article

  

Authors:	Kushner, B. H.; Kramer, K.; LaQuaglia, M. P.; Cheung, N. K. V.
Article Title:	Curability of recurrent disseminated disease after surgery alone for local-regional neuroblastoma using intensive chemotherapy and anti-GD2 immunotherapy
Abstract:	Purpose: A reluctance to treat local-regional neuroblastoma by surgery alone derives partly from concern that if widespread neuroblastoma develops, the chance for cure is small, and partly from hope that mild chemotherapy will prevent relapse. The authors report on a series of patients who had distant recurrences after surgery alone for local-regional neuroblastoma. Methods: Seven patients treated with surgery alone for local-regional neuroblastoma had widespread relapses 2.5 to 25 (median 7) months later and were treated at Memorial Sloan-Kettering Cancer Center (MSKCC). During the period of this study (1995-1999), MSKCC patients with high-risk neuroblastoma received the N7 protocol (dose-intensive chemotherapy, immunotherapy with the anti-GD2 3F8 antibody, targeted radiotherapy using 131I-3F8, local radiotherapy) if they had assessable disease, or 3F8 plus granulocyte-macrophage colony-stimulating factor (GM-CSF) followed by 13-cis-retinoic acid if they were in remission after treatment elsewhere. Results: Five patients were in complete remission 3 years 11 months to 7 years 4 months from the start of retrieval therapy, including three who received all of their N7 treatment of relapsed neuroblastoma at MSKCC, one who received two cycles of chemotherapy elsewhere before starting N7, and one who was referred for 3F8/GM-CSF because of neuroblastoma cells in pretransplantation bone marrow. Conclusions: The encouraging survival results of our cohort are consistent with the concept that surgery alone for local-regional neuroblastoma might be beneficial to the overall neuroblastoma population because many patients will never need chemotherapy (and will therefore be spared its potential toxicities), and most of those who do have widespread relapses are likely to be cured with contemporary treatments.
Keywords:	cancer chemotherapy; cancer survival; child; clinical article; treatment outcome; child, preschool; cancer surgery; unclassified drug; doxorubicin; drug efficacy; cancer radiotherapy; combined modality therapy; recurrent cancer; cancer immunotherapy; pain; bone marrow suppression; etoposide; mucosa inflammation; peripheral neuropathy; granulocyte macrophage colony stimulating factor; relapse; cyclophosphamide; vincristine; molecular marker; cancer regression; immunotherapy; iodine radioisotopes; infant; neuroblastoma; ganglioside gd2; hypothyroidism; isotretinoin; radioimmunotherapy; hearing impairment; urticaria; monoclonal antibody 3f8 i 131; cheilitis; ganglioside antibody; granulocyte macrophage colony-stimulating factors, recombinant; humans; prognosis; human; male; female; priority journal; article; nonstage 4 disease; ganglioside gd2 monoclonal antibody 3f8
Journal Title:	Journal of Pediatric Hematology/Oncology
Volume:	25
Issue:	7
ISSN:	1077-4114
Publisher:	Lippincott Williams & Wilkins
Date Published:	2003-07-01
Start Page:	515
End Page:	519
Language:	English
DOI:	10.1097/00043426-200307000-00003
PUBMED:	12847316
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-0037634528&partnerID=40&md5=0dcb590febb84b324a32e6026924d451
Notes:	Export Date: 12 September 2014 -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/59775