Less Chemo for Some Children

A recent study shows that excellent results may be achieved using a lot less chemotherapy than the current standard for a particularly aggressive form of childhood cancer called neuroblastoma.

Published in the Sept. 30, 2010, issue of The New England Journal of Medicine, the eight-year-long, phase 3 study results exceeded the researchers’ goal of reducing chemotherapy exposure by at least 40 percent while maintaining the 90 percent survival rate achieved with higher doses.

The Children’s Oncology Group followed 479 infants and children newly diagnosed with intermediate-risk (stage 3 and stage 4) neuroblastoma for a median of about five years.

Patients with favorable tumor biology received four cycles of chemotherapy over three months—a 70 percent reduction in duration from the 10 cycles over nine months used in earlier trials. Those who failed to respond after four cycles received an additional four. And patients with unfavorable tumor biology received eight cycles over six months—a 40 percent reduction in treatment duration.

The entire group had an overall survival rate of 96 percent, with 98 percent of patients with favorable tumors living at least three years and 93 percent of patients with unfavorable tumors living at least three years.

“This trial will lead to permanent treatment reductions in our protocol for treating this disease and will have a significant impact on the hundreds of children who are diagnosed with neuroblastoma each year,” says senior study author Katherine Matthay, MD, of the University of California San Francisco Benioff Children’s Hospital in a press statement.