IMMUNOTHERAPY WITH ANTI-GD2 MONOCLONAL ANTIBODIES IN HIGH-RISK NEUROBLASTOMA PATIENTS ON AN OUTPATIENT BASIS

Q4 Medicine

Pediatriya - Zhurnal im G.N. Speranskogo Pub Date : 2023-06-01 DOI:10.24110/0031-403x-2023-102-3-50-56

M.V. Natrusova, G.O. Bronin, B.M. Kurmanov, V.V. Konstantinova, A.V. Lifshits, E.A. Zhuravel, N.V. Bronina, E.A. Burtsev, E.V. Kumirova

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引用次数: 0

Abstract

Neuroblastoma (NB) is the most common extracranial solid tumor in childhood. Prior to the introduction of intensive multimodal therapy, overall survival (OS) in patients with high-risk NB was below 15%. The addition of immunotherapy with dinutuximab beta in post-consolidation to multimodal treatment can increase the 5-year event-free survival rate for patients with high-risk NB up to 56.6%, and the 5-year OS up to 73.2%. The purpose of the research was to study the efficacy and safety of dinutuximab beta therapy in high-risk NB patients. Materials and methods used: the study included 8 pediatric patients with high-risk NB who had been treated with dinutuximab beta immunotherapy during postconsolidation on the basis of the Morozov Children’s City Clinical Hospital (Moscow, Russia) in 2020 to 2022. In case a patient's vital parameters normalization coupled with the absence of the need for accompanying therapy for 24 hours in a hospital, the patient was then considered as a candidate for outpatient treatment with possible no need for admission in the hospital. Results: 6 patients (75%) completed the full course of therapy with dinutuximab beta. The course of immunotherapy was not completed in 2 patients due to further progression of the disease. The most common adverse events were recorded as follows: pain (100%), fever (100%), diarrhea (62.5%), edematous syndrome (37.5%), allergic reactions (25%), hematological toxicity (25%). The period of time to becoming the candidates for outpatient treatment was 10.38±2.56 days for the 1st cycle of therapy and 2.67±1.63 days for the last, 5th cycle of the immunotherapy. In 6 out of 8 cases described the immunotherapy with dinutuximab beta allowed maintaining the response to treatment achieved after the end of consolidation preventing further development of the disease. The overall good tolerance to the drug made it possible to carry out the immunotherapy on an outpatient basis using microinfusing pump. Conclusion: an adequate route of administration and accompanying treatment make dinutuximab beta toxicity profile sufficient for outpatient management of patients with high-risk NB.

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抗gd2单克隆抗体在门诊高危神经母细胞瘤患者中的免疫治疗

神经母细胞瘤(NB)是儿童最常见的颅外实体瘤。在引入强化多模式治疗之前，高危NB患者的总生存率(OS)低于15%。在多模式治疗的基础上，在巩固后加入迪努妥昔单抗免疫治疗，可使高危NB患者5年无事件生存率提高56.6%，5年OS提高73.2%。本研究的目的是研究迪努妥昔单抗治疗高危NB患者的疗效和安全性。使用的材料和方法:本研究纳入8例高危NB患儿，均为2020 - 2022年在俄罗斯莫罗佐夫儿童城市临床医院(Moscow, Russia)巩固后接受迪努妥昔单抗β免疫治疗的患儿。如果患者的重要参数恢复正常，且不需要在医院进行24小时的伴随治疗，则将该患者视为门诊治疗的候选者，可能不需要住院。结果:6例患者(75%)完成了迪努妥昔单抗治疗的整个疗程。2例患者因病情进一步恶化未能完成免疫治疗。最常见的不良反应为:疼痛(100%)、发热(100%)、腹泻(62.5%)、水肿综合征(37.5%)、过敏反应(25%)、血液毒性(25%)。第一次免疫治疗周期为10.38±2.56 d，第5次免疫治疗周期为2.67±1.63 d。在8例病例中，有6例使用迪努妥昔单抗进行免疫治疗，可以在巩固结束后保持对治疗的反应，防止疾病的进一步发展。对药物的总体良好耐受性使得在门诊基础上使用微输液泵进行免疫治疗成为可能。结论:适当的给药途径和伴随的治疗使迪努妥昔单抗β毒性分析足以用于高危NB患者的门诊管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatriya - Zhurnal im G.N. Speranskogo Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

自引率

0.00%

发文量

150

期刊介绍： Journal “Pediatria” named after G.N. Speransky (the official short names of the Journal are “Journal «Pediatria»,” “Pediatria,” and “«Pediatria,» the Journal”) is the oldest Soviet-and-Russian (in the Russian Federation, the CIS and former Soviet Union) scientific and practical medical periodical assigned for pediatricians that is published continuously since May, 1922, and distributed worldwide. Our mission statement specifies that we aim to the ‘raising the level of skills and education of pediatricians, organizers of children’s health protection services, medicine scientists, lecturers and students of medical institutes for higher education, universities and colleges worldwide with an emphasis on Russian-speaking audience and specific, topical problems of children’s healthcare in Russia, the CIS, Baltic States and former Soviet Union Countries and their determination with the use of the World’s best practices in pediatrics.’ As part of this objective, the Editorial of the Journal «Pediatria» named after G.N. Speransky itself adopts a neutral position on issues treated within the Journal. The Journal serves to further academic discussions of topics, irrespective of their nature - whether religious, racial-, gender-based, environmental, ethical, political or other potentially or topically contentious subjects. The Journal is registered with the ISSN, - the international identifier for serials and other continuing resources, in the electronic and print world: ISSN 0031-403X (Print), and ISSN 1990-2182 (Online). The Journal was founded by the Academician, Dr. Georgiy Nestorovich SPERANSKY, in May, 1922. Now (since 1973) the Journal bears his honorary name.