Urinary Catecholamines Predict Relapse During Complete Remission in High-Risk Neuroblastoma

Area of Science:

• Pediatric Oncology
• Biomarker Discovery
• Cancer Therapeutics

Background:

• Urinary catecholamines are established neuroblastoma diagnostic markers.
• Their role in monitoring treatment response and predicting outcomes remains unclear.
• Current response criteria do not include catecholamine levels.

Purpose of the Study:

• To investigate urinary catecholamines for response monitoring in high-risk neuroblastoma.
• To assess their predictive value for survival outcomes.
• To evaluate catecholamines in relation to complete remission (CR).

Main Methods:

• Measured eight urinary catecholamines in 153 high-risk neuroblastoma patients from 2005-2021.
• Assessed catecholamine levels at diagnosis (Dx), during treatment, and at CR.
• Correlated catecholamine status with event-free survival (EFS) and overall survival (OS) using revised International Neuroblastoma Response Criteria.

Main Results:

• Elevated catecholamines were detected in 97% at Dx, 81% postinduction, and 57% at CR.
• Primary tumor resection significantly reduced catecholamine levels (P < .01).
• Positive catecholamine status at CR correlated with poor EFS (38% vs. 80%, P < .01) and OS (52% vs. 86%, P = .01).
• Elevated 3-methoxytyramine at CR predicted poor OS (HR, 7.5).

Conclusions:

• Urinary catecholamine measurements aid in assessing CR in high-risk neuroblastoma.
• Positive catecholamine status at CR identifies patients at increased risk of relapse and death.
• Catecholamine levels offer prognostic value beyond current response criteria.