Therapy intensification in high-risk neuroblastoma patients with  poor response to standard induction: experience of Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology

T. V. Shamanskaya; Шаманская Т. В.; D. Y. Kachanov; Качанов Д. Ю.; A. V. Dumacheva; Думачева А. В.; M. V. Teleshova; Телешова М. В.; D. V. Shevtcov; Шевцов Д. В.; T. V. Sergeeva; Сергеева Т. В.; A. M. Syleimanova; Сулейманова А. М.; R. A. Moiseenko; Моисеенко Р. А.; Y. N. Likar; Ликарь Ю. Н.; . Kailash; Кайлаш .; S. R. Varfolomeeva; Варфоломеева С. Р.

doi:10.24287/1726-1708-2019-18-4-19-28

Therapy intensification in high-risk neuroblastoma patients with poor response to standard induction: experience of Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology

Authors: Shamanskaya T.V.¹, Kachanov D.Y.¹, Dumacheva A.V.¹, Teleshova M.V.¹, Shevtcov D.V.², Sergeeva T.V.¹, Syleimanova A.M.², Moiseenko R.A.¹, Likar Y.N.¹, Kailash .¹, Varfolomeeva S.R.²
Affiliations:
1. Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
2. N.N. Blokhin National Medical Research Center of Oncology оf the Ministry of Health of the Russian Federation
Issue: Vol 18, No 4 (2019)
Pages: 19-28
Section: ORIGINAL ARTICLES
Submitted: 29.12.2019
Accepted: 29.12.2019
Published: 29.12.2019
URL: https://hemoncim.com/jour/article/view/280
DOI: https://doi.org/10.24287/1726-1708-2019-18-4-19-28
ID: 280

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Abstract

High-risk neuroblastoma (NB) is characterized by unsatisfactory treatment results and low probability of long-term survival despite the multimodal therapeutic approach (chemotherapy, surgical treatment, radiation therapy, autologous hematopoietic stem cell transplantation, etc.). One of the prognostic factors in this cohort of patients is the response to induction therapy. The article presents the experience of the intensification of induction therapy in 12 patients with high-risk NB with a poor response (mixed response, stable disease) to standard induction therapy who received treatment at Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, assessing its impact on the prognosis of the disease. The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. Patients received an additional two courses of chemotherapy with the inclusion of a type I topoisomerase inhibitor topotecan (TCE – topotecan, cyclophosphamide, etoposide). This regimen of intensification of therapy has demonstrated its feasibility. The main grade 3–4 toxicity was hematologic. An improvement in response was achieved in 5/12 (41.6%) patients. However, long-term results of therapy remained unsatisfactory. The 3-year EFS was 16.7% (95% CI 0.0–37.8), the 3-year OS was 50.0% (95% CI 21.7–78.3). Thus, the intensification of therapy in patients with high-risk NB with a poor response to standard induction therapy did not improve treatment outcomes.

Keywords

neuroblastoma, children, high-risk group, induction therapy, topotecan

About the authors

T. V. Shamanskaya

Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation

Email: shamanskaya.tatyana@gmail.com
ORCID iD: 0000-0002-3767-4477

Correspondence: Tatyana V. Shamanskaya, MD, PhD,Scientific Secretary,Institute ofOncology, Radiology and Nuclear Medicine, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare ofRussian Federation.

Address: Russia 117997, Moscow,Samory Mashela st., 1

Russian Federation

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