Localized infant neuroblastomas often show spontaneous regression: results of the prospective trials NB95-S and NB97 - PubMed (original) (raw)
Controlled Clinical Trial
. 2008 Mar 20;26(9):1504-10.
doi: 10.1200/JCO.2007.12.3349.
Affiliations
- PMID: 18349403
- DOI: 10.1200/JCO.2007.12.3349
Controlled Clinical Trial
Localized infant neuroblastomas often show spontaneous regression: results of the prospective trials NB95-S and NB97
Barbara Hero et al. J Clin Oncol. 2008.
Abstract
Purpose: The excellent prognosis of localized neuroblastoma in infants, the overdiagnosis observed in neuroblastoma screening studies, and several case reports of regression of localized neuroblastoma prompted us to initiate a prospective cooperative trial on observation of localized neuroblastoma without cytotoxic treatment.
Patients and methods: For infants with localized neuroblastoma without MYCN amplification, chemotherapy was scheduled only in cases with threatening symptoms; otherwise, the tumor was either resected or observed by ultrasound and magnetic resonance imaging (MRI).
Results: Of 340 eligible participants, 190 underwent resection, 57 were treated with chemotherapy, and 93 were observed with gross residual tumor. Of those 93 patients with unresected tumors, spontaneous regression was seen in 44, local progression in 28, progression to stage 4S in seven, and progression to stage 4 in four. Time to regression was quite variable, with first signs of regression noted 1 to 18 months after diagnosis and in 15 of 44 patients even after the first year of life. So far, complete regression was observed in 17 of 44 patients 4 to 20 months after diagnosis. Known clinical risk factors were not able to differentiate between patients with regression and regional or metastatic progression. Overall survival (OS; 3-year OS, 0.99 +/- 0.01) and metastases-free survival (rate at 3 years, 0.94 +/- 0.03) for patients with unresected tumors was excellent and was not different from patients treated with surgery or chemotherapy.
Conclusion: Spontaneous regression is regularly seen in infants with localized neuroblastoma and is not limited to the first year of life. A wait-and-see strategy is justified in those patients.
Trial registration: ClinicalTrials.gov NCT00002803 NCT00017225.
Similar articles
- Excellent outcome with reduced treatment for infants with disseminated neuroblastoma without MYCN gene amplification.
De Bernardi B, Gerrard M, Boni L, Rubie H, Cañete A, Di Cataldo A, Castel V, Forjaz de Lacerda A, Ladenstein R, Ruud E, Brichard B, Couturier J, Ellershaw C, Munzer C, Bruzzi P, Michon J, Pearson AD. De Bernardi B, et al. J Clin Oncol. 2009 Mar 1;27(7):1034-40. doi: 10.1200/JCO.2008.17.5877. Epub 2009 Jan 26. J Clin Oncol. 2009. PMID: 19171711 Clinical Trial. - Stage 4S neuroblastoma, a disseminated tumor with excellent outcome.
Elimam NA, Atra AA, Fayea NY, Al-Asaad TG, Khattab TM, Al-Sulami GA, Felimban SK. Elimam NA, et al. Saudi Med J. 2006 Nov;27(11):1734-6. Saudi Med J. 2006. PMID: 17106552 - "Wait and see" strategy in localized neuroblastoma in infants: an option not only for cases detected by mass screening.
Fritsch P, Kerbl R, Lackner H, Urban C. Fritsch P, et al. Pediatr Blood Cancer. 2004 Nov;43(6):679-82. doi: 10.1002/pbc.20126. Pediatr Blood Cancer. 2004. PMID: 15390301 - Perinatal neuroblastoma.
Nuchtern JG. Nuchtern JG. Semin Pediatr Surg. 2006 Feb;15(1):10-6. doi: 10.1053/j.sempedsurg.2005.11.003. Semin Pediatr Surg. 2006. PMID: 16458841 Review. - [Management strategy in neuroblastoma].
Balwierz W. Balwierz W. Przegl Lek. 2004;61 Suppl 2:3-8. Przegl Lek. 2004. PMID: 15686038 Review. Polish.
Cited by
- Event-free survival in neuroblastoma with MYCN amplification and deletion of 1p or 11q may be associated with altered immune status.
Wei Z, Gong B, Li X, Chen C, Zhao Q. Wei Z, et al. BMC Cancer. 2024 Oct 15;24(1):1279. doi: 10.1186/s12885-024-13044-5. BMC Cancer. 2024. PMID: 39407175 Free PMC article. - A subset of image-defined risk factors predict completeness of resection in children with high-risk neuroblastoma: An international multicenter study.
Espinoza AF, Bagatell R, McHugh K, Naranjo AH, Van Ryn C, Rojas Y, Lyons K, Guillerman RP, Kirby C, Brock P, Volchenboum S, Simon T, States L, Miller A, Krug B, Sarnacki S, Irtan S, Brisse HJ, Valteau-Couanet D, von Schweinitz D, Kammer B, Granata C, Pio L, Park JR, Nuchtern JG. Espinoza AF, et al. Pediatr Blood Cancer. 2024 Oct;71(10):e31218. doi: 10.1002/pbc.31218. Epub 2024 Jul 28. Pediatr Blood Cancer. 2024. PMID: 39072986 - Advances in liquid biopsy in neuroblastoma.
Zhuo Z, Lin L, Miao L, Li M, He J. Zhuo Z, et al. Fundam Res. 2022 Aug 17;2(6):903-917. doi: 10.1016/j.fmre.2022.08.005. eCollection 2022 Nov. Fundam Res. 2022. PMID: 38933377 Free PMC article. Review. - Extracellular vesicles in neuroblastoma: role in progression, resistance to therapy and diagnostics.
Dhamdhere MR, Spiegelman VS. Dhamdhere MR, et al. Front Immunol. 2024 Apr 9;15:1385875. doi: 10.3389/fimmu.2024.1385875. eCollection 2024. Front Immunol. 2024. PMID: 38660306 Free PMC article. Review. - Prognostic factors for intermediate- or high-risk neuroblastomas in children in China.
Zhang Y, Zhang WL, Huang DS, Wang YZ, Hu HM, Zhi T, Mei YY. Zhang Y, et al. BMC Pediatr. 2023 Dec 6;23(1):617. doi: 10.1186/s12887-023-04258-w. BMC Pediatr. 2023. PMID: 38053080 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical