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. 2022 Dec 23:12:1041443.
doi: 10.3389/fonc.2022.1041443. eCollection 2022.

Dinutuximab beta plus conventional chemotherapy for relapsed/refractory high-risk neuroblastoma: A single-center experience

Nur Olgun  1 , Emre Cecen  1 , Dilek Ince  1 , Deniz Kizmazoglu  1 , Birsen Baysal  1 , Ayse Onal  1 , Ozhan Ozdogan  2 , Handan Guleryuz  3 , Riza Cetingoz  4 , Ayse Demiral  4 , Mustafa Olguner  5 , Ahmet Celik  6 , Serra Kamer  7 , Erdener Ozer  8 , Zekiye Altun  9 , Safiye Aktas  9
Affiliations

Dinutuximab beta plus conventional chemotherapy for relapsed/refractory high-risk neuroblastoma: A single-center experience

Nur Olgun et al. Front Oncol. .

Abstract

Background: Relapsed/refractory high-risk neuroblastoma has a dismal prognosis. Anti-GD2-mediated chemo-immunotherapy has a notable anti-tumor activity in patients with relapsed/refractory high-risk neuroblastoma. The purpose of this study was to analyze the efficacy and safety of the combination of immunotherapy with dinutuximab beta (DB) and chemotherapy in patients with relapsed/refractory high-risk neuroblastoma.

Methods: All patients received the Turkish Pediatric Oncology Group NB 2009 national protocol for HR-NB treatment at the time of diagnosis. Salvage treatments were administered after progression or relapse. The patients who could not achieve remission in primary or metastatic sites were included in the study. The most common chemotherapy scheme was irinotecan and temozolomide. DB was administered intravenously for 10 days through continuous infusion with 10 mg/m2 per day. The patients received 2 to 14 successive cycles with duration of 28 days each. Disease assessment was performed after cycles 2, 4, and 6 and every 2 to 3 cycles thereafter.

Results: Between January 2020 and March 2022, nineteen patients received a total of 125 cycles of DB and chemotherapy. Objective responses were achieved in 12/19 (63%) patients, including complete remission in 6/19 and partial response in 6/19. Stable disease was observed in two patients. The remaining five patients developed bone/bone marrow and soft tissue progression after 2-4 cycles of treatment. The most common Grade ≥3 toxicities were leukopenia, thrombocytopenia, hypertransaminasemia, fever, rash/itching and capillary leak syndrome, respectively.

Conclusion: Our study results suggest that DB-based chemo-immunotherapy seems to be suitable with encouraging response rates in patients with relapsed/refractory high-risk neuroblastoma.

Keywords: anti-GD2; dinutuximab beta; neuroblastoma; refractory; relapsed.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
MIBG in patient no. 3 (the above) and patient no. 10 (below). Patient no. 3, (A); prior to therapy with DB and chemotherapy (SIOPEN score of 21), (B); After 6 cycles of treatment complete regression of the skeletal metastases and the soft tissue mass (SIOPEN score of 0), (C); 6 months after the end of DB and chemotherapy (SIOPEN score of 0). Patient no. 10, (D); prior to therapy with DB and chemotherapy (SIOPEN score of 41), (E); After 6 cycles of treatment complete regression of the skeletal metastases and substantial regression the soft tissue mass-primary tumor (SIOPEN score of 1, black arrow), (F); 6 months after the end of DB and chemotherapy (SIOPEN score of 0).
See this image and copyright information in PMC

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