ANR 2010 ~ UK group reports on long-term survival with persistent neuroblastoma

SEL 10 (p. 136) “Persistence of disease in long-term survivors of high-risk neuroblastoma. Analysis of ENSG5 cooperative trial”

Presented by Lucas Moreno of UK

A report on long-term survivors of high-risk neuroblastoma with persistent (refractory) disease was presented at ANR by Lucas Moreno on Tuesday as one of the selected posters in the clinical session.

This is the first time persistence of disease in long-term survivors has ever been studied.

The European trial ENSG5 randomized 262 children from 1990 to 1999 (and an additional 177 children were not randomized) to two different induction regimens: same chemotherapy and dose, but different time schedule consisting of 21-day chemotherapy schedule (OPEC/OJEC) versus 10-day schedule (rapid COJEC), then all went on to autologous transplant. This study reports on children who did NOT reach remission at the end of induction and were alive 5 years after diagnosis.

In this study, 62 children with refractory neuroblastoma at the end of induction were alive at five years after diagnosis. Two groups were defined, those with persistent metastatic disease (group 1) and those with persistent primary disease (group 2).

Of those with persistent metastatic disease after 5 years, 2 had bone marrow disease up to 9 years after diagnosis, and 6 had persistent MIBG positive skeletal (bone) disease up to 16 years after diagnosis.

Of those with persistent primary site disease, 7 still had disease up to 16 years after diagnosis.

The group reports that “some patients can be long-term survivors despite persistent disease.”

I think this is encouraging news for refractory neuroblastoma.