Neuroblastoma unmet clinical needs

Neuroblastoma (NB) is known as the most common cancer diagnosed in the population aged below a year old. It is a heterogeneous disease, and prognostic factors, such as age, clinical view, histologicalobservations, and genetics analysis can determine how useful the therapy is going to be. From epidemiological point of view, it is reported that > 20% of all cancers detected during the first year of life are NB cases. 5% of all pediatric cancers, while causing 10% of total cancer mortalities in this age group. In 2004 a group named International NB risk group (INRG) started a 12-year study on 8800 patients which resulted in a risk classification system. They have considered thirteen prognostic factors, while seven of these factors were identified as the most important ones at the time of tumor diagnosis. Age of diagnosis, tumor stage, tumor histology, tumour differentiation grade, DNA ploidy, MYCN and 11q copy numbers. The outcome was to divide patients into four groups of very low risk, low risk, intermediate risk, and high risk. Although many achievements have been accomplished through many years of studying on NB, today many children cannot be cured or will suffer from long lasting side effects of available therapies. Illustrating significant need to reach new therapies with low toxicity and more efficacy. This will require using NGS tools and immunotherapies targeting key pathways and genetic alterations. Further GWAS investigations will be needed for identifying more genetic role players as personalized medicine is becoming an increasingly important strategy in the treatment of advanced stage NB. Some other suggestions include development of preventive strategies by exploring various risk factors. Improvement of current INRG classification system and combination of ALK inhibitors and mTOR inhibitors that resulted in increased survival and tumor-regression.

کلیدواژه ها:

Gene and Cancer ، Cell and Cancer ، Multidisciplinary Cancer Research ، Cancer Genetics ، Targeted Cancer Therapy