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N7: A novel multi-modality therapy of high risk neuroblastoma (NB) in children dignosed over 1 year of age

Lookup NU author(s): Simon Cotterill, Professor Louise Parker, Emeritus Professor Alan Craft


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Background. The N7 protocol for poor-risk neuroblastoma uses dose-intensive chemotherapy (as in N6 protocol [Kushner et al.:] Clin Oncol 12:2607-2613, 1994] but with lower dosing of vincristine) for induction, surgical resection and 2100 cGy hyperfractionated radiotherapy for local control, and for consolidation, targeted radioimmunotherapy with 131I-labeled anti-GD2 3F8 monoclonal antibody and immunotherapy with unlabeled/unmodified 3F8 (400 mg/m2). Procedure. The chemotherapy consists of: cyclophosphamide 70 mg/kg/d × 2 and a 72-hr infusion of doxorubicin 75 mg/m2 plus vincristine 2 mg/m2, for courses 1, 2, 4, and 6; and cisplatin 50 mg/m2/d × 4 and etoposide 200 mg/m2/d × 3, for courses 3, 5, and 7. 131I-3F8 is dosed at 20 mCi/kg, which is myeloablative and therefore necessitates stem-cell support. Results. Of the first 24 consecutive previously untreated patients more than 1 year old at diagnosis, 22 were stage 4 and two were unresectable stage 3 with MYCN amplification. Chemotherapy achieved CR/VGPR in 21 of 24 patients. Twenty patients to date have completed treatment with 131I-3F8, and 15 patients have completed all treatment. With a median follow-up of 19 months, 18 of 24 patients remain progression-free. Conclusions. Major toxicities were grade 4 myelosuppression and mucositis during chemotherapy, and self-limited pain and urticaria during antibody treatment. Late effects include hearing deficits and hypothyroidism. © 2001 Wiley-Liss, Inc.

Publication metadata

Author(s): Cotterill, S. J., Parker, L., More, L., Craft, A. W.

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: 8th Advances in Neuroblastoma Research Conference (1998)

Year of Conference: 2001

Pages: 227-230

Publisher: Medical and Pediatric Oncology: John Wiley & Sons, Inc.

DOI: 10.1002/1096-911X(20010101)36:1<227::AID-MPO1055>3.0.CO;2-U

PubMed id: 11464891