Improved treatments for high – risk neuroblastoma patients
The plan of attack
One aim is to find an improved treatment method for patients with high risk neuroblastoma using a standard intensive very high dose consolidation chemotherapy known as myeloablative therapy (MAT), followed by an additional immunotherapy treatment after MAT to reduce the risk of relapse and increase the survival of patients with high risk neuroblastoma.
If the patient is enrolled on the study, they will be able to receive addition of immunotherapy which includes a humanised mouse antibody (ch14.18/CHO) with a man – made protein (aldesleukin (IL – 2)) that has been shown to dramatically improve patient outcomes.
The current high – risk study is seeking to answer two questions:
Which schedule of chemotherapy gives the best results in induction (the first chemotherapy treatment given)? The study will compare the current standard European protocol of ‘Rapid COJEC’ with an alternative regimen previously used in North America (known as ‘modified N7’).
During immunotherapy, does the addition of IL2 to anti – GD2 antibody treatment improve outcomes without unacceptable side effects? This part of the trial has reached adequate patient numbers and the results are being analysed.
Results so far
We have treated dozens of children on this study and have many survivors now several years down the track in excellent health.
Some of the questions posed in the current high – risk study have already been answered, leading to the routine use of G – CSF during induction chemotherapy and one particular type of chemotherapy used for high – dose/myeloablative treatment. Collaborate
The KCC is lead co – ordinating site for national studies to high risk neuroblastoma trials through the international neuroblastoma study group (SIOPEN).
This large international study began in 2010, and involves collaboration with more than 20 countries, and 15 collaborative groups. Currently, in Australia, John Hunter Children’s Hospital and Sydney Children’s Hospital, Randwick participate in this study. The Royal Children’s Hospital in Melbourne will soon be joining this study.
The results of the study will continue to change the standard treatment plans in Australia, the USA and Europe and will continue to influence the way we treat all patients with neuroblastoma moving forward.