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High-Dose, Rapid-Induction Chemotherapy Increases Event-Free Survival in Children With Neuroblastoma

NEW YORK -- February 26, 2008 -- An intensive chemotherapy regimen combined with a shorter duration between induction treatments improves event-free survival among paediatric patients with high-risk neuroblastoma compared with the current standard. The experimental regimen increased survival rates by two-thirds, according to the findings reported in the March 2008, issue of the Lancet Oncology.

The researchers noted that the results of this trial have led to the roll out of more a rapid chemotherapy method across Europe.

Scientists from the Children's Cancer and Leukaemia Group enrolled 262 children aged 1 year and older with high-risk, stage 4 neuroblastoma into the 10-year study. Patients were randomly assigned to the standard every-21-day regimen (n = 132) or to rapid treatment every 10 days (n = 130) at 1.8 times the conventional dose.

The study results indicated that 5-year event-free survival rates increased by 12 percent in the patients assigned to the rapid 10-day technique (30.2% vs 18.2%; P = .022). Ten-year event-free survival was also higher in the rapid-treatment group (27.1% vs 18.2%), but the difference did not reach statistical significance. However, the rapid induction strategy reduced the time to myeloablation by 55 days.

Safety findings show that rates of infective complications, including febrile neutropenia and septicaemia, and time in hospital were higher in the rapid-treatment group. Fungal infection rates were the same in both groups.

Professor Andy Pearson, lead author of the paper and Cancer Research UK's Professor of Paediatric Oncology at The Institute of Cancer Research and the Royal Marsden Hospital in Sutton, UK, noted, "Our method of chemotherapy increases the survival rates for children with high-risk neuroblastoma and is already saving the lives of many children. Using a higher dose and having chemotherapy with shorter breaks between each treatment means that fewer children will die from the disease each year."


Source: Lancet Oncology, March 2008

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