快速的COJEC,没有神经母细胞瘤高风险的神经母细胞瘤的骨髓衰变疗法
Brian H Kushner1, Ellen M Basu1, Fiorella Iglesias Cardenas1
1Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
International journal of cancer
|July 16, 2025
概括
骨髓缩疗法 (MAT) 不是高风险神经母细胞瘤 (HR-NB) 治疗的必要条件. 没有MAT的快速COJEC化疗显示了与包括MAT在内的疗法相比的生存率,为HR-NB患者提供了潜在的较少毒性替代方案.
科学领域:
- 儿科瘤学 儿科瘤学
- 癌症治疗方法 癌症治疗方法
- 神经母细胞瘤研究 神经母细胞瘤研究
背景情况:
- 骨髓缩疗法 (MAT) 是COG和SIOPEN的高风险神经母细胞瘤 (HR-NB) 治疗方案的标准组成部分.
- 纪念斯隆凯特林癌症中心 (MSK) 使用的治疗策略不包括 MAT.
- 现有数据表明,COG/SIOPEN与MAT的协议和没有MAT的MSK协议之间存在类似的无事件生存率 (约50%-60%在3-5年).
研究的目的:
- 在HR-NB患者中评估快速COJEC化疗方案没有MAT的结果.
- 将这种修改方法的疗效和安全性与包括MAT在内的历史数据进行比较.
- 评估抗GD2单克隆抗体 (mAb) naxitamab在这种治疗模式中的作用.
主要方法:
- 对28名HR-NB患者的回顾性分析,他们接受了快速COJEC治疗,但不是MAT,在MSK没有先前的进展性疾病.
- 患者在2017年1月至2023年6月期间在naxitamab.b的可用性期间接受治疗.
- 结果根据COJEC后远程疾病的存在进行了分层 (第一组:没有远程疾病;第二组:持续转移).
主要成果:
- 第1组的所有10名患者 (没有COJEC后的远程疾病) 在平均3.5+年内保持无事件,接受了naxitamab + GM-CSF +/-疫苗.
- 在第二组 (持续转移) 的18名患者中,有12名患者在平均2.4年以上的时间内保持无复发,接受了各种二线治疗,包括纳西他马布+GM-CSF.
- 在第二组的3名患者中观察到二次瘤,其中2例髓质可塑性综合征成功治疗,1例甲状腺癌.
结论:
- 在快速COJEC化疗后避免MAT似乎不会对HR-NB患者的无事件生存产生负面影响.
- 这些发现支持了快速COJEC与naxitamab基础免疫疗法相结合的潜力,作为包括MAT的治疗方案的有效替代方案.
- 这种方法可能为HR-NB提供一种不那么密集的治疗选择,需要进一步调查.
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