Neuroblastoma outcomes improved with second stem cell transplant
Dr Julie Park - Seattle Children's Hospital, Seattle, USA
The trial that I presented today was on behalf of the Children’s Oncology Group which is one of the National Cancer Institute cancer clinical trial networks consortium.
Can you tell us what you were working with and the results that you found for neuroblastoma?
Our trial that we performed within the Children’s Oncology Group we studied whether the addition of a tandem myeloablative chemotherapy, so two myeloablative chemotherapies, would improve outcome for high risk neuroblastoma compared to one and we showed that the tandem transplant does improve outcome.
Can you tell us more about the patients you’re working with and the risks that are faced by neuropathy and the treatments as well?
The children that were enrolled on this trial are children that have what is termed high risk neuroblastoma and we define that looking at clinical and biological characteristics. We know that that group of children have a very poor outcome and with current standard therapy less than half of those children will survive. So enrolling on a trial to improve their outcome is certainly a major theme and major effort on our part. The therapy itself is very aggressive, it is total therapy of about 15-18 months of therapy but our goal at the end is to have more children survive and live long-term.
And just go over what were the changes to schedule in terms of the timing of the transplants?
The standard transplant is one transplant delivering three medications. The tandem transplant is two transplants separated by 6-8 weeks so it adds about three months to the treatment for children.
And then in terms of the survival what kinds of benefits are found with the additional?
We found that there was a marked decrease in the risk for recurrence in those children who received a tandem transplant. About 61% at three years had not had a recurrence whereas those children who had had a standard single transplant 48% were without recurrence.
So how do you recommend taking this data moving forwards into standard practice?
The Children’s Oncology Group has recommended that this become the standard of treatment for patients with high risk neuroblastoma.