None — Neuroblastoma
Neuroblastoma is a type of cancer that forms in certain types of primitive nerve cells. About one-third of these cancers form in the adrenal glands (hormone secreting glands located on top of the kidneys). Another third start in the sympathetic nerves in the abdomen. The rest form in the sympathetic nerves in the spine, neck, chest or pelvis.
The American Cancer Society estimates about 650 new cases of neuroblastoma are diagnosed annually in the U.S. The cancer almost exclusively occurs in young children and is rare after age 10. Researchers say it is the most common type of cancer in infants and the second most common type of solid tumor in children. The median age at diagnosis is 18 months.
The most common symptom of neuroblastoma is a lump or swelling in the stomach, chest, or neck. The mass itself is usually not painful. However, it can cause pain and other symptoms as the tumor presses on surrounding tissue. In 2/3 of patients, the disease has already spread at the time of diagnosis. Some common sites of metastasis include the bones, bone marrow and skin.
Treating Neuroblastoma
Stephan Grupp, M.D., Pediatric Oncologist with the Children's Hospital of Philadelphia, says neuroblastoma is one of the most difficult childhood cancers to treat. Typical treatment involves high doses of chemotherapy, surgery, radiation therapy and, often, bone marrow transplant. The treatments may last a year or longer and are tough for children and their families. In addition, while the intensive treatment may initially put the cancer in remission, it often doesn't lead to a cure. Researchers estimate that more than 50 percent of children with neuroblastoma eventually have a recurrence. The average time from diagnosis to recurrence is about 18 months. Once the disease recurs, it is very difficult to treat.
One potential option for treatment-resistant neuroblastoma is immunotherapy using monoclonal antibodies. Monoclonal antibodies are antibodies made from specific immune cells. They are developed to specifically target substances on cancer cells, allowing the patient's own body to attack and destroy the cancer cells. In the case of neuroblastoma, researchers are targeting a sugar on the surface of the neuroblastoma cells, called GD2, which prevents the immune system from attacking the cancer cells. The monoclonal antibody, ch14.18, binds to GD2, allowing the immune system to go after the cancer.
To boost the activity of the antibody, two hormones are added to the cocktail. The drugs are then given through an IV drip. The treatment is given monthly over four to five days for about five months.
In a recent study, researchers compared the effectiveness of immunotherapy plus standard therapy against standard therapy alone. After two years, 66 percent of those in the immunotherapy group were still alive, versus only 44 percent of those in the standard treatment group. Thus, immunotherapy produced a 20 percent improvement in cure rates. The researchers were so impressed with the results that immunotherapy was later offered to those who only received standard treatment.
Grupp says immunotherapy is usually given after the patient has gone through standard treatment. There are side effects associated with immunotherapy, like pain, accumulation of fluid and potential allergic reactions. Therefore, researchers are continuing to search for other treatments that use the immune system to target neuroblastoma cells.
For information about neuroblastoma:
American Cancer Society Association of Cancer Online Resources The Children's Neuroblastoma Cancer Foundation CureSearch for Children's Cancer National Cancer Institute
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