N7: A novel multi-modality therapy of high risk neuroblastoma (NB) in children diagnosed over 1 year of age Journal Article


Authors: Cheung, N. K. V.; Kushner, B. H.; Laquaglia, M.; Kramer, K.; Gollamudi, S.; Heller, G.; Gerald, W.; Yeh, S.; Finn, R.; Larson, S. M.; Wuest, D.; Byrnes, M.; Dantis, E.; Mora, J.; Cheung, I. Y.; Rosenfield, N.; Abramson, S.; O'Reilly, R. J.
Article Title: N7: A novel multi-modality therapy of high risk neuroblastoma (NB) in children diagnosed over 1 year of age
Abstract: Background. The N7 protocol for poor-risk neuroblastoma uses dose-intensive chemotherapy (as in N6 protocol [Kushner et al.:] Clin Oncol 12:2607-2613, 1994] but with lower dosing of vincristine) for induction, surgical resection and 2100 cGy hyperfractionated radiotherapy for local control, and for consolidation, targeted radioimmunotherapy with 131I-labeled anti-GD2 3F8 monoclonal antibody and immunotherapy with unlabeled/unmodified 3F8 (400 mg/m2). Procedure. The chemotherapy consists of: cyclophosphamide 70 mg/kg/d × 2 and a 72-hr infusion of doxorubicin 75 mg/m2 plus vincristine 2 mg/m2, for courses 1, 2, 4, and 6; and cisplatin 50 mg/m2/d × 4 and etoposide 200 mg/m2/d × 3, for courses 3, 5, and 7. 131I-3F8 is dosed at 20 mCi/kg, which is myeloablative and therefore necessitates stem-cell support. Results. Of the first 24 consecutive previously untreated patients more than 1 year old at diagnosis, 22 were stage 4 and two were unresectable stage 3 with MYCN amplification. Chemotherapy achieved CR/VGPR in 21 of 24 patients. Twenty patients to date have completed treatment with 131I-3F8, and 15 patients have completed all treatment. With a median follow-up of 19 months, 18 of 24 patients remain progression-free. Conclusions. Major toxicities were grade 4 myelosuppression and mucositis during chemotherapy, and self-limited pain and urticaria during antibody treatment. Late effects include hearing deficits and hypothyroidism. © 2001 Wiley-Liss, Inc.
Keywords: child; clinical article; treatment outcome; child, preschool; disease-free survival; survival analysis; cisplatin; doxorubicin; cancer combination chemotherapy; dose response; multimodality cancer therapy; conference paper; cancer radiotherapy; chemotherapy, adjuvant; combined modality therapy; radiotherapy, adjuvant; neoplasm staging; gene amplification; etoposide; antineoplastic combined chemotherapy protocols; neoplasm proteins; tumor markers, biological; risk factors; cyclophosphamide; vincristine; monoclonal antibody; antibodies, monoclonal; immunoglobulin g; iodine radioisotopes; neuroblastoma; radiation dose fractionation; genes, myc; remission induction; high risk population; chromosome aberrations; hypothyroidism; dose fractionation; radioimmunotherapy; hyperfractionated radiotherapy; antibody dependent cellular cytotoxicity; complement dependent cytotoxicity; 3f8; immunoconjugates; myeloablative agent; immunization, passive; bone marrow diseases; dose intensity; gross total resection; humans; human; male; female; priority journal; anti-gd2
Journal Title: Medical and Pediatric Oncology
Volume: 36
Issue: 1
ISSN: 0098-1532
Publisher: Wiley Liss  
Date Published: 2001-01-01
Start Page: 227
End Page: 230
Language: English
DOI: 10.1002/1096-911x(20010101)36:1<227::aid-mpo1055>3.0.co;2-u
PUBMED: 11464891
PROVIDER: scopus
DOI/URL:
Notes: Presented at the Advances in Neuroblastoma Research Meeting; 1998 Jun 15-17; Bath, England -- Export Date: 22 February 2016 -- Source: Scopus
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MSK Authors
  1. Samuel D J Yeh
    54 Yeh
  2. Brian Kushner
    191 Kushner
  3. Glenn Heller
    301 Heller
  4. Nai-Kong Cheung
    446 Cheung
  5. David L Wuest
    28 Wuest
  6. Kim Kramer
    170 Kramer
  7. Jaime Mora
    25 Mora
  8. Ronald D Finn
    251 Finn
  9. Nancy S Rosen
    27 Rosen
  10. William L Gerald
    369 Gerald
  11. Irene Y Cheung
    75 Cheung
  12. Steven M Larson
    772 Larson
  13. Richard O'Reilly
    486 O'Reilly
  14. Ester C Dantis
    4 Dantis