Wednesday, September 29, 2010 (Last Updated: 09/29/2010)
WEDNESDAY, Sept. 29 (HealthDay News) -- High-risk neuroblastoma patients may experience increased survival with immunotherapy treatment instead of standard treatment, and intermediate-risk neuroblastoma patients may fare well with a biologically-based treatment and reduced chemotherapy regimen, according to two articles published in the Sept. 30 issue of the New England Journal of Medicine.
Alice L. Yu, M.D., of the University of California in San Diego, and colleagues randomly assigned 226 high-risk neuroblastoma patients to standard therapy or immunotherapy consisting of isotretinoin with concomitant cycles of ch14.18 combined with alternating granulocyte-macrophage colony-stimulating factor and interleukin-2. They found that immunotherapy improved the rate of event-free survival compared with standard therapy (66 versus 46 percent) and overall survival (86 versus 75 percent).
David L. Baker, M.D., of the Princess Margaret Hospital for Children in Perth, Australia, and colleagues assigned 479 patients with intermediate-risk neuroblastoma to a tumor biology-based therapy to see if reduced duration of therapy and drug doses can maintain a three-year estimated overall survival of more than 90 percent. The three-year estimated overall survival was 96 percent for the whole group, 98 percent in patients whose tumors had favorable biologic features, and 93 percent in patients whose tumors had biologically unfavorable features.
"A very high rate of survival among patients with intermediate-risk neuroblastoma was achieved with a biologically-based treatment assignment involving a substantially reduced duration of chemotherapy and reduced doses of chemotherapeutic agents as compared with the regimens used in earlier trials. These data provide support for further reduction in chemotherapy with more refined risk stratification," Baker and colleagues conclude.
Bayer provided the granulocyte-macrophage colony-stimulating factor for the first study.
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