Treatment Options for Neuroblastoma
Treatment of low-risk neuroblastoma may include the following:
- Surgery followed by observation.
- Chemotherapy with or without surgery, for some patients.
- Observation alone for infants who do not have signs or symptoms of neuroblastoma. More studies are needed before this is considered a standard treatment.
Treatment of intermediate-risk neuroblastoma may include the following:
- Chemotherapy with or without surgery.
- Surgery alone for infants.
- Observation alone for certain infants.
- Radiation therapy to treat tumors that are causing serious problems and do not respond quickly to chemotherapy or surgery.
- Radiation therapy for tumors that do not respond to other treatment.
Treatment of high-risk neuroblastoma may include the following:
- A regimen of combination chemotherapy, surgery, stem cell rescue, radiation therapy, and anti-GD2 ch14.18 with interleukin-2 (IL-2), granulocyte-macrophage colony-stimulating factor (GM-CSF), and isotretinoin.
- A clinical trial of combination chemotherapy and stem cell rescue following chemotherapy.
- A clinical trial of chemotherapy combined with mIBG, followed by surgery, more chemotherapy, stem cell rescues, radiation therapy, and isotretinoin.
- A clinical trial of chemotherapy and stem cell rescue followed by isotretinoin with or without monoclonal antibody therapy and biologic therapy.
- Observation with supportive care for certain patients who have favorable tumor biology and do not have signs or symptoms.
- Chemotherapy, for children who have signs or symptoms of neuroblastoma or unfavorable tumor biology, or for very young infants.
Patients First Treated for Low-Risk Neuroblastoma
Treatment for recurrent neuroblastoma that has spread to other parts of the body may include the following:
- Observation for certain infants.
- Surgery followed by chemotherapy.
- Combination chemotherapy.
Patients First Treated for Intermediate-Risk Neuroblastoma
Recurrent neuroblastoma that has spread to other parts of the body is treated the same way as newly diagnosed high-risk neuroblastoma.
Patients First Treated for High-Risk Neuroblastoma
- Combination chemotherapy.
- mIBG therapy to relieve symptoms and improve quality of life. It may be given alone or in combination with other therapy, or after stem cell rescue.
- A second course of high-dose chemotherapy and stem cell rescue.
Because there is no standard treatment for recurrent neuroblastoma in patients first treated for high-risk neuroblastoma, patients may want to consider a clinical trial. For information about clinical trials, please see the NCI Web site.
Patients with Recurrent CNS Neuroblastoma
- Surgery to remove the tumor in the CNS followed by radiation therapy.
- A clinical trial of a new therapy.
Treatments in Clinical Trials for Progressive/Recurrent Neuroblastoma
- Combination chemotherapy and ch14.18 monoclonal antibody therapy.
- Lenalidomide and ch14.18 monoclonal antibody therapy with or without isotretinoin.
- Vaccine therapy.
- A tyrosine kinase inhibitor (crizotinib) with or without combination chemotherapy.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with neuroblastoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the NCI Web site.