Neuroblastoma-A Review of Combination Immunotherapy

Abstract

Neuroblastoma is the most common extracranial solid tumor found in childhood and is responsible for 15% of deaths among children with cancer. Although multimodal therapies focused on surgery, chemotherapy, radiotherapy, and stem cell transplants have favorable results in many cases, the use of conventional therapies has probably reached the limit their possibility. Almost half of the patients with neuroblastoma belong to the high-risk group. Patients in this group require a combination of several therapeutic approaches. It has been shown that various immunotherapies combined with conventional methods can work synergistically. Due to the development of such therapeutic methods, we present combinations and forms of combining immunotherapy, focusing on their mechanisms and benefits but also their limitations and potential side effects.

Keywords: cancer; combining therapy; immunotherapy; neuroblastoma; pediatric oncology.

Figure 1

Two-dimensional Chemical Structure of GD2 Ganglioside [27].

Figure 2

Mechanism of action of anti-GD2 monoclonal antibody: anti-GD2 mAb binds to GD2 disialoganglioside, which is highly expressed on the surface of NB cells and activates complement. Anti-GD2 monoclonal antibody mediates CDC and ADCC, which are induced by neutrophils and NK cells. These cells bind antibodies. ADCC and, thus, the antitumor effect can be increased using immunostimulating cytokines: IL-2 targeting the interleukin-2 receptor (IL-2R) and GM-CSF targeting the GM-CSF receptor (GM-CSFR). Created with BioRender.com (accessed on 24 June 2024).

Figure 3

Two-dimensional Chemical Structure of Irinotecan [39].

Figure 4

Two-dimensional Chemical Structure of Temozolomide [40].