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A subset analysis of a phase II trial evaluating the use of DFMO as maintenance therapy for high-risk neuroblastoma |
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| Authors: | Elizabeth C. Lewis Jacqueline M. Kraveka William Ferguson Don Eslin Valerie I. Brown Genevieve Bergendahl William Roberts Randal K. Wada Javier Oesterheld Deanna Mitchell Jessica Foley Peter Zage Jawhar Rawwas Maria Rich Elizabeth Lorenzi Kristine Broglio Donald Berry Giselle L. Saulnier Sholler |
| Affiliation: | 1. Helen DeVos Children's Hospital at Spectrum Health, Grand Rapids, Michigan, USA;2. Medical University of South Carolina, Charleston, South Carolina, USA;3. St. Louis University School of Medicine, St. Louis, Missouri, USA;4. Arnold Palmer Hospital for Children, Orlando, Florida, USA;5. Penn State Health Children's Hospital at the Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA;6. Rady Children's Hospital-San Diego and UC San Diego School of Medicine, San Diego, California, USA;7. Kapiolani Medical Center for Women and Children, Honolulu, Hawaii, USA;8. Levine Children's Hospital, Charlotte, North Carolina, USA;9. Helen DeVos Children's Hospital at Spectrum Health, Grand Rapids, Michigan, USA Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA;10. Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota, USA;11. Berry Consultants, LLC, Austin, Texas, USA |
| Abstract: | Neuroblastoma is a sympathetic nervous system tumor, primarily presenting in children under 6 years of age. The long-term prognosis for patients with high-risk neuroblastoma (HRNB) remains poor despite aggressive multimodal therapy. This report provides an update to a phase II trial evaluating DFMO as maintenance therapy in HRNB. Event-free survival (EFS) and overall survival (OS) of 81 subjects with HRNB treated with standard COG induction, consolidation and immunotherapy followed by 2 years of DFMO on the NMTRC003/003b Phase II trial were compared to a historical cohort of 76 HRNB patients treated at Beat Childhood Cancer Research Consortium (BCC) hospitals who were disease-free after completion of standard upfront therapy and did not receive DFMO. The 2- and 5-year EFS were 86.4% [95% confidence interval (CI) 79.3%-94.2%] and 85.2% [77.8%-93.3%] for the NMTRC003/003b subset vs 78.3% [69.5%-88.3%] and 65.6% [55.5%-77.5%] for the historical control group. The 2- and 5-year OS were 98.8% [96.4-100%] and 95.1% [90.5%-99.9%] vs 94.4% [89.3%-99.9%] and 81.6% [73.0%-91.2%], respectively. DFMO maintenance for HRNB after completion of standard of care therapy was associated with improved EFS and OS relative to historical controls treated at the same institutions. These results support additional investigations into the potential role of DFMO in preventing relapse in HRNB. |
| Keywords: | DFMO high-risk neuroblastoma maintenance |