Neuroblastoma chemoimmunotherapy: current results and application prospects

Neuroblastoma (NB) is the most common extracranial solid tumor of childhood affecting children from 0 to 14 years old. Despite the achievements of modern multimodal risk-adapted therapy, the prognosis in patients with high-risk NB remains unfavorable. Numerous research groups have shown that a good response achieved at the time of completion of the induction stage of therapy in this subgroup of patients correlates with survival rates. Thus, improving the response to induction therapy may be a potential mechanism for improving long-term survival rates. Over the past few decades, traditional approaches to cancer therapy have undergone a radical revolution, largely due to the development and implementation of the immunotherapy method. It is known that combined antitumor therapy is superior to monotherapy and is one of the tools for overcoming heterogeneous drug resistance. A vast number of preclinical studies has shown that GD2-directed monoclonal antibodies (mAbs) are able to enhance the cytostatic effects of chemotherapeutic drugs, which has become a promising model for clinical studies of various chemoimmunotherapy regimens, which have demonstrated convincing evidence of safety and an acceptable toxicity profile with an encouraging effect on objective response rates, overall and event-free survival in both patients with recurrent, refractory NB, and primary patients of the high-risk group.The article discusses fundamental ideas about the synergistic interaction of GD2-directed mAbs in combination with cytostatic agents, the role of response to the induction stage of therapy and prospects for the use of induction chemoimmunotherapy as a method of improving postinduction response, event-free and overall survival in patients with NB.