|
|||||
|
|
Impact of diagnostic and end-of-induction Curie scores with tandem high-dose chemotherapy and autologous transplants for metastatic high-risk neuroblastoma: A report from the Children's Oncology Group |
|
| Authors: | Keri A Streby Marguerite T Parisi Barry L Shulkin Brian LaBarre Rochelle Bagatell Lisa Diller Stephan A Grupp Katherine K Matthay Stephan D Voss Alice L Yu Wendy B London Julie R Park Gregory A Yanik Arlene Naranjo |
| Institution: | 1. Division of Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA;2. Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA
Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA;3. Department of Radiological Sciences, St. Jude Children's Research Hospital, University of Tennessee Health Science Center, Memphis, Tennessee, USA;4. Children's Oncology Group Statistics & Data Center, Department of Biostatistics, University of Florida, Gainesville, Florida, USA;5. Department of Pediatrics, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania, USA;6. Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA;7. Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California, USA;8. Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA;9. University of California in San Diego, San Diego, California, USA Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan;10. Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA;11. Division of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, United 12. States |
| Abstract: | BackgroundDiagnostic mIBG (meta-iodobenzylguanidine) scans are an integral component of response assessment in children with high-risk neuroblastoma. The role of end-of-induction (EOI) Curie scores (CS) was previously described in patients undergoing a single course of high-dose chemotherapy (HDC) and autologous hematopoietic cell transplant (AHCT) as consolidation therapy.ObjectiveWe now examine the prognostic significance of CS in patients randomized to tandem HDC and AHCT on the Children's Oncology Group (COG) trial ANBL0532.Study designA retrospective analysis of mIBG scans obtained from patients enrolled in COG ANBL0532 was performed. Evaluable patients had mIBG-avid, International Neuroblastoma Staging System (INSS) stage 4 disease, did not progress during induction therapy, consented to consolidation randomization, and received either single or tandem HDC (n = 80). Optimal CS cut points maximized the outcome difference (≤CS vs. >CS cut-off) according to the Youden index.ResultsFor recipients of tandem HDC, the optimal cut point at diagnosis was CS = 12, with superior event-free survival (EFS) from study enrollment for patients with CS ≤ 12 (3-year EFS 74.2% ± 7.9%) versus CS > 12 (59.2% ± 7.1%) (p = .002). At EOI, the optimal cut point was CS = 0, with superior EOI EFS for patients with CS = 0 (72.9% ± 6.4%) versus CS > 0 (46.5% ± 9.1%) (p = .002).ConclusionIn the setting of tandem transplantation for children with high-risk neuroblastoma, CS at diagnosis and EOI may identify a more favorable patient group. Patients treated with tandem HDC who exhibited a CS ≤ 12 at diagnosis or CS = 0 at EOI had superior EFS compared to those with CS above these cut points. |
| Keywords: | Curie score mIBG neuroblastoma tandem |