Retinoids and immunotherapy
Retinoids and immunotherapy are sometimes used to treat neuroblastoma. Retinoids are a form of vitamin A that help some cancer cells mature (differentiate) into normal cells. Immunotherapy helps to direct the body's own immune system to kill any remaining neuroblastoma cells.
Retinoids and immunotherapy may be used to treat high-risk or recurrent neuroblastoma. They are given after high-dose chemotherapy and stem cell rescue, and may be called maintenance therapy. Retinoids and immunotherapy drugs are used to:
- kill any remaining cancer cells
- stop cancer cells from growing and spreading
- lower the risk that the cancer will come back (recur)
Retinoid drugs used for neuroblastoma @(Model.HeadingTag)>
The retinoid used for high-risk or recurrent neuroblastoma is isotretinoin. It is given by mouth for 6 months after high-dose chemotherapy and stem cell rescue.
Immunotherapy drugs used for neuroblastoma @(Model.HeadingTag)>
There are different immunotherapy drugs used to treat neuroblastoma.
Monoclonal antibodies are a type of targeted immunotherapy used to treat neuroblastoma. Dinutuximab (Unituxin) is a
Granulocyte growth factors (such as G-CSF) may be used to lessen some of the side effects of cancer treatments. They stimulate the bone marrow to make more white blood cells. This helps reduce the risk of infection after chemotherapy. For immunotherapy, a different growth factor called GM-CSF (sargramostim) is used to stimulate the immune system. It is given by an injection under the skin.
Interleukins are a group of hormone-like substances made by white blood cells. They stimulate the immune system to recognize and destroy cancer cells. Until recently, interleukin-2 (Aldesleukin, Proleukin) was used as part of immunotherapy for neuroblastoma. But evidence from studies in Europe now suggests that the addition of interleukin-2 does not appear to be as important, so it is no longer used routinely for most patients receiving immunotherapy for high-risk neuroblastoma.
Side effects @(Model.HeadingTag)>
Side effects can happen with any type of treatment for neuroblastoma, but every child’s experience is different. Some children have many side effects. Others have few or none at all.
Side effects of retinoids and immunotherapy will depend mainly on the type of drug or drug combination, the dose and your child's overall health.
Some common side effects of retinoids include:
- skin problems
- dry lips, mouth, nose and eyes
- muscle and joint pains
- changes in nails
- flu-like symptoms
- nerve pain
- leaking of fluid in the body
- changes in blood pressure and heart rate
- swelling or fluid retention
- allergic reaction
- nausea and vomiting
- low white blood cell count
Tell the healthcare team if your child has these side effects or others you think might be from retinoids or immunotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help your child deal with them.
Information about specific cancer drugs @(Model.HeadingTag)>
Meredith Irwin, MD
Daniel Morgenstern, MD
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Yu AL, Hilman AL, Ozkaynak MF, et al . A phase III randomized trial of the chimeric anti-GD2 antibody ch14.18 with GM-CSF and IL2 as immunotherapy following dose intensive chemotherapy for high-risk neuroblastoma: Children's Oncology Grop (COG) study ANBL0032. Journal of Clinical Oncology. American Society of Clinical Oncology; 2009.