Open AccessMYCN-amplified stage 2/3 neuroblastoma: excellent survival in the era of anti-GD2 immunotherapy
Author(s) -
Brian H. Kushner,
Michael P. LaQuaglia,
Shakeel Modak,
Suzanne L. Wolden,
Ellen M. Basu,
Stephen S. Roberts,
Kim Krämer,
Karima Yataghene,
Irene Y. Cheung,
NaiKong V. Cheung
Publication year - 2017
Publication title -
oncotarget
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.373
H-Index - 127
ISSN - 1949-2553
DOI - 10.18632/oncotarget.20513
Subject(s) - medicine , neuroblastoma , autologous stem cell transplantation , immunotherapy , oncology , stage (stratigraphy) , progressive disease , survival analysis , progression free survival , surgery , chemotherapy , cancer , paleontology , genetics , biology , cell culture
High-risk neuroblastoma (HR-NB) includes MYCN -amplified stage 2/3, but reports covering anti-G D2 immunotherapy, which recently became standard for HR-NB, do not provide details on this subset. We now report on all 20 MYCN -amplified stage 2/3 patients who received induction chemotherapy at our center during the era of consolidation with anti-G D2 antibody 3F8/ granulocyte-macrophage colony-stimulating factor (GM-CSF) (2000-2015). Early in this period, consolidation included autologous stem-cell transplantation (ASCT). Event-free survival (EFS) and overall survival (OS) were estimated using Kaplan-Meier analyses. With induction, 19/20 (95%) patients achieved complete/very good partial remission (CR/VGPR) but one had progressive disease with early death. One responder did not receive consolidation and died of relapse. Five-year post-diagnosis EFS/OS rates for all 20 patients were 72%/84%. The 18 CR/VGPR patients who received consolidation had EFS/OS 81%/94% at five years from starting 3F8/GM-CSF: 4/4 ASCT patients remained relapse-free, while 11/14 non-ASCT patients remained relapse-free and two of the three relapsed patients achieved 2 nd CR (consolidated by retreatment with 3F8/GM-CSF) and remained in 2 nd CR at 36+ and 95+ months post-relapse. The 14 non-ASCT patients had EFS/OS 73.5%/93% at five years from starting 3F8/GM-CSF. This subset appears to have a good prognosis with contemporary multi-modality therapy, possibly even without ASCT.