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Important research into neuroblastoma is under way right now
in many university hospitals, medical centers, and other institutions
around the world. Each year, scientists find out more about what causes
the disease and how to improve treatment.
Classifying neuroblastomas
Researchers now have better tools to look for changes in the
genes of neuroblastoma cells. They have made a great deal of progress
in recent years in to help doctors find out which neuroblastomas are
likely to be cured with standard treatment, and which will need more
aggressive treatment.
For example, using newer lab tests, researchers recently found
that certain DNA changes on the short arm of chromosome 6 (6p22) were
more likely to be seen in neuroblastomas that grew more aggressively.
In the near future, doctors may be able to use these types of
test results to aid in choosing treatments.
Treatment
In recent years, survival rates from childhood cancers have
improved. Most of these results have come when doctors find ways to
improve on the use of already available and accepted therapies. For
example, studies are helping doctors learn which combinations of drugs
are more likely to improve survival.
Chemotherapy: Doctors
continue to search for the best combinations of chemotherapy drugs to
treat neuroblastoma. Several drugs that are already used to treat other
cancers, such as topotecan, irinotecan, and temozolomide, are now being
studied for use against neuroblastoma as well.
Stem cell
transplants: Doctors are also trying to improve the
success rate with high-dose chemotherapy and stem cell transplants,
using different combinations of chemotherapy, radiation therapy,
retinoids, and other treatments. Some clinical trials are studying the
use of more than one stem cell transplant in the same patient.
Retinoids:
Retinoids such as 13-cis-retinoic acid (isotretinoin) have shown
promise in reducing the risk of recurrence after treatment. Newer,
potentially more effective retinoids, such as fenretinide, are now
being developed and studied in clinical trials.
Newer forms of
treatment: Knowledge about what makes neuroblastoma cells
different from normal cells may lead to new approaches to treating this
disease. Several newer forms of therapy, which target neuroblastoma
cells more specifically than standard treatments, are now being studied
in clinical trials.
For example, monoclonal antibodies are manmade versions of
immune system proteins that can be made to attack a very specific
target. These molecules can be injected into the body to seek out and
attach to cancer cells. Monoclonal antibodies have been developed to
attach to the ganglioside GD2, a substance found on the surface of many
neuroblastoma cells.
Some of these antibodies are used by themselves to try to
stimulate the body's immune system to attack the cancer, while others
are first attached to radioactive particles or chemotherapy drugs. By
zeroing in on their targets, these antibodies than can deliver
chemotherapy or radiation to the neuroblastoma cells with minimal
damage to normal cells. Early results of these treatments have shown
promise, but they are available only in clinical trials at this time.
Forms of gene therapy and cancer vaccines are also being
studied for use against neuroblastoma, although these treatments are
still in the earliest stages of clinical trials.
Last Medical Review: 10/22/2008 Last Revised: 10/22/2008
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