title: Evidence for the efficacy of immunotherapy in children with high-risk neuroblastoma.
abstract: Neuroblastoma is the most common extra-cranial malignancy of childhood, with the highest incidence in children younger than 4 years. The prognosis depends on many factors, such as age at diagnosis, stage of disease and molecular genetic subtype. More than 50% of children who present with the disease are deemed to have high-risk neuroblastoma. The standard therapy for children with high-risk neuroblastoma consists of intensive chemotherapy, surgery, radiotherapy, myeloablative consolidation with autologous haematopoietic stem cell rescue followed by the treatment of minimal residual disease with 13-cis-retinoic acid. Unfortunately, more than half of the patients relapse regardless of the treatment intensity. Combined therapy with monoclonal antibodies (anti-GD2), intravenous interleukin-2 (Il-2), intravenous granulocyte-macrophage colony-stimulating factor (GM-CSF) and oral 13-cis-retinoic acid have been proved to be effective in some randomised trials. A better understanding of the underlying immunological processes in therapy with anti-GD2 antibodies will allow its success to be evaluated more accurately and direct future endeavours. Nevertheless, the long-term benefit of this treatment approach needs to be established.
authors.affiliation: The Institute of Cancer Research, London, UK.
authors.forename: Elwira
authors.initials: E
authors.lastname: Szychot
authors.affiliation: Department of Paediatric Oncology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Peregud-Pogorzelski
authors.affiliation: Department of Paediatric Oncology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Wawryków
authors.affiliation: Department of Paediatrics, Nephrology with Dialysis Therapy and Management of Acute Poisoning, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Brodkiewicz
mesh_terms: D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy; D007223:Infant; D007376:Interleukin-2 / Q000627:therapeutic use; D015474:Isotretinoin / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local; D009447:Neuroblastoma / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007376:Interleukin-2; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D015474:Isotretinoin