Addition of immunotherapy boosts paediatric cancer survivalin children with neuroblastoma

Administering a new form of immunotherapy to children with neuroblastoma, a nervous system cancer, increased the percentage of those who were alive and free of disease progression after two years, according to researchers at the University of California, San Diego School of Medicine and fellow institutions.

The percentage rose from 46 percent for children receiving a standard therapy to 66 percent for children receiving immunotherapy plus standard therapy, according to the study published in the Sept. 30, 2010 issue of the New England Journal of Medicine.

''This is the first clinical trial to document that a combination of anti-cancer monoclonal antibody (mAb) with cytokines is an effective anti-cancer therapy,'' said Alice L. Yu, MD, PhD, study chair and Professor of Pediatric Hematology Oncology at Moores UCSD Cancer Center. ''This is also the first time a mAb targeting a glycolipid is shown to be effective for cancer immunotherapy since all therapeutic anti-cancer mAbs previously approved by FDA are directed against protein antigen.

Overall, these findings present a clear paradigm shift and establish immunotherapy as a cornerstone to high-risk neuroblastoma treatment. This immunotherapy regimen will now be standard of care for children in first remission.''

Neuroblastoma is a cancer of the peripheral nervous system (found outside of the brain and spinal cord), and is responsible for 12 percent of all deaths due to cancer in children under 15 years of age. It is the most common non-brain solid tumor in children. Nearly 50 percent of patients with neuroblastoma have a high-risk form of the disease and have poor long-term survival despite very intensive treatment.

The previously established standard treatment for neuroblastoma uses high doses of chemotherapy to destroy as many cancer cells as possible. But this form of chemotherapy (myleoablative therapy) also destroys some normal blood-forming cells, so it is followed by giving back previously collected blood-forming cells to restore immune system function and blood cell formation. Patients who respond to this therapy are then given a derivative of vitamin A to further treat any remaining cancer cells. More than half of the patients with high-risk neuroblastoma treated in this manner succumb to the disease.