The researches find that the based on prognostic markers, including allelic status of chromosomes 1p and 11q, patients were initially assigned to receive two, four, or eight cycles of therapy with or without surgery; the ultimate duration of treatment was based on overall response. The researchers found that subsets of patients had a reduction in treatment compared with the legacy Children’s Oncology Group studies. The three-year event-free survival rate was 83.2%, and the overall survival rate was 94.9%.

Eight cycles of chemotherapy

Compared with patients with one or more unfavorable biologic features; infants with stage 4 tumors with favorable biology had superior three-year event-free survival (86.9 versus 66.8%); they also had a trend toward overall survival advantage (95.0 versus 86.7%). For patients with localized disease; overall survival was 100 percent. “Using this response- and biology-based algorithm that includes the allelic status of 1p36 and 11q23; excellent survival is achieve with refined treatment strategies for specific subsets of intermediate-risk patients;” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry. Use of a response- and biology-based treatment algorithm for intermediate-risk neuroblastoma is associate with excellent survival and reduces treatment for some patients;l according to a study published online Aug. 6 in the Journal of Clinical Oncology. Neuroblastoma is the most common extracranial solid tumor in childhood. More than 650 cases are diagnosed each year in the United States.

Intermediate-risk neuroblastoma

The prevalence is about 1 case per 7,000 live births; the incidence is about 10.54 cases per 1 million per year in children younger than 15 years. About 37% of patients are diagnosed as infants, and 90% are younger than 5 years at diagnosis; with a median age at diagnosis of 19 months. The data on age at diagnosis show that this is a disease of infancy; with the highest rate of diagnosis in the first month of life. The incidence of neuroblastoma in black children is slightly lower than the incidence in white children. However; there are also racial differences in tumor biology; with African Americans more likely to have high-risk disease and fatal outcomes.

Population-based studies of screening for infants with neuroblastoma have demonstrated that spontaneous regression of neuroblastoma without clinical detection in the first year of life is at least as prevalent as clinically detected neuroblastoma. Epidemiologic studies have shown that environmental or other exposures have not been unequivocally associated with increased or decreased incidences of neuroblastoma. Studies analyzing constitutional DNA in rare cohorts of familial neuroblastoma patients have provided insight into the complex genetic basis for tumor initiation. About 1% to 2% of patients with neuroblastoma have a family history of neuroblastoma. These children are; on average, younger (9 months at diagnosis) and about 20% have multifocal primary neuroblastoma.