Comparison of pain outcomes between two anti-GD2 antibodies in patients with neuroblastoma.
Addition of anti-GD2 antibody ch14.18 to the treatment of neuroblastoma has improved outcomes. The most common side effect of ch14.18 is neuropathic pain, which may in part be complement-mediated. Hu14.18K322A is a humanized anti-GD2 antibody designed to diminish complement activation and induce less pain. We compare the pain outcomes in patients treated with ch14.18 and those treated with hu14.18K322A, and explore dose-dependent relationships between pain scores, opioid requirements, and complement levels in patients treated with hu14.18K322A.



Opioid (morphine equivalent mg/kg) and anxiolytic requirements during course 1 (4 days) in patients treated with hu14.18K322A and ch14.18 were reviewed. Correlations between antibody dose and pain scores, opioid requirements, and complement levels were examined for patients receiving hu14.18K322A.



Patients treated with hu14.18K322A (n = 19) had lower opioid requirements than those who received ch14.18 (n = 9). The differences in median opioid requirements (mg/kg) were statistically significant for the overall course (1.57 vs. 2.41, P = 0.019) as well as for Days 3 (0.34 vs. 0.65, P = 0.005), and 4 (0.32 vs. 0.64, P = 0.010). No difference in anxiolytic use was observed between the two groups. In the group treated with hu14.18K322A, we found a positive correlation between antibody dose administered and pain scores, but no correlation between antibody dose and opioid requirements or changes in complement levels.



In this retrospective analysis, hu14.18K322A induced less pain than ch14.18 based on opioid requirements. Pediatr Blood Cancer 2015;62:224-228. © 2014 Wiley Periodicals, Inc.
St. Jude Children's Research Hospital, Memphis, Tennessee.
Doralina L
DL
Anghelescu
St. Jude Children's Research Hospital, Memphis, Tennessee.
Jacob L
JL
Goldberg
St. Jude Children's Research Hospital, Memphis, Tennessee.
Lane G
LG
Faughnan
St. Jude Children's Research Hospital, Memphis, Tennessee.
Jianrong
J
Wu
St. Jude Children's Research Hospital, Memphis, Tennessee.
Shenghua
S
Mao
St. Jude Children's Research Hospital, Memphis, Tennessee.
Wayne L
WL
Furman
St. Jude Children's Research Hospital, Memphis, Tennessee.
Victor M
VM
Santana
St. Jude Children's Research Hospital, Memphis, Tennessee.
Fariba
F
Navid
D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003167:Complement Activation / Q000276:immunology; D003169:Complement Inactivator Proteins / Q000627:therapeutic use*; D003165:Complement System Proteins / Q000187:drug effects; D005260:Female; D005732:Gangliosides / Q000037:antagonists & inhibitors* / Q000276:immunology; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007223:Infant; D008297:Male; D009437:Neuralgia / Q000188:drug therapy*; D009447:Neuroblastoma / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003169:Complement Inactivator Proteins; D005732:Gangliosides; C000624155:Hu14.18K322A monoclonal antibody; C019403:ganglioside, GD2; C112746:dinutuximab; D003165:Complement System Proteins
anti-GD2 antibodies; neuroblastoma; opioids; pain; pediatric oncology