Neuroblastoma treatment in the post-genomic era.
Neuroblastoma is an embryonic malignancy of early childhood originating from neural crest cells and showing heterogeneous biological, morphological, genetic and clinical characteristics. The correct stratification of neuroblastoma patients within risk groups (low, intermediate, high and ultra-high) is critical for the adequate treatment of the patients.High-throughput technologies in the Omics disciplines are leading to significant insights into the molecular pathogenesis of neuroblastoma. Nonetheless, further study of Omics data is necessary to better characterise neuroblastoma tumour biology. In the present review, we report an update of compounds that are used in preclinical tests and/or in Phase I-II trials for neuroblastoma. Furthermore, we recapitulate a number of compounds targeting proteins associated to neuroblastoma: MYCN (direct and indirect inhibitors) and downstream targets, Trk, ALK and its downstream signalling pathways. In particular, for the latter, given the frequency of ALK gene deregulation in neuroblastoma patients, we discuss on second-generation ALK inhibitors in preclinical or clinical phases developed for the treatment of neuroblastoma patients resistant to crizotinib.We summarise how Omics drive clinical trials for neuroblastoma treatment and how much the research of biological targets is useful for personalised medicine. Finally, we give an overview of the most recent druggable targets selected by Omics investigation and discuss how the Omics results can provide us additional advantages for overcoming tumour drug resistance.
Paediatric Research Institute, Fondazione Città della Speranza, Neuroblastoma Laboratory, Corso Stati Uniti, 4, Padua, 35127, Italy. mr.esposito@irpcds.org.
Maria Rosaria
MR
Esposito
Paediatric Research Institute, Fondazione Città della Speranza, Neuroblastoma Laboratory, Corso Stati Uniti, 4, Padua, 35127, Italy.
Sanja
S
Aveic
Department of Biology, University of Padua, Padua, Italy.
Anke
A
Seydel
Paediatric Research Institute, Fondazione Città della Speranza, Neuroblastoma Laboratory, Corso Stati Uniti, 4, Padua, 35127, Italy.
Gian Paolo
GP
Tonini
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D000077547:Crizotinib; D016503:Drug Delivery Systems / Q000379:methods*; D019008:Drug Resistance, Neoplasm / Q000187:drug effects / Q000235:genetics; D023281:Genomics; D006801:Humans; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors / Q000235:genetics / Q000378:metabolism; D009447:Neuroblastoma / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism; D011720:Pyrazoles / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D009363:Neoplasm Proteins; D011720:Pyrazoles; D011725:Pyridines; D000077547:Crizotinib
Neuroblastoma; Omics; Personalised medicine; Targeted therapy