Skip to main content
Journal cover image

Predictors of differential response to induction therapy in high-risk neuroblastoma: A report from the Children's Oncology Group (COG).

Publication ,  Journal Article
Pinto, N; Naranjo, A; Hibbitts, E; Kreissman, SG; Granger, MM; Irwin, MS; Bagatell, R; London, WB; Greengard, EG; Park, JR; DuBois, SG
Published in: Eur J Cancer
May 2019

BACKGROUND: Induction chemotherapy plays an important role in the management of patients with high-risk neuroblastoma. Predictors of response to induction therapy are largely lacking. We sought to describe clinical and biological features associated with induction response. METHODS: Patients from four consecutive COG high-risk trials were included. Response was evaluated by the 1993 International Neuroblastoma Response Criteria. The primary end-point was end-induction partial response (PR) or better. Univariate analyses were performed to compare response as a function of clinical or biologic predictors. A multivariate logistic regression model using significant predictors from univariate analyses was constructed to model PR or better. RESULTS: The analytic cohort included 1242 patients. End-induction response ≥PR was significantly associated with higher event-free and overall survival. Baseline factors associated with ≥PR included age <18 months (87.4% with ≥PR vs. 78.7% if older; p = 0.0103), International Neuroblastoma Staging System non-stage 4 (89.0% vs. 78.4% if stage 4; p = 0.0016), MYCN amplification (85.5% vs. 77.1% if non-amplified; p = 0.0006), 1p loss of heterozygosity (LOH; 85.6% vs. 76.0% if no LOH; p = 0.0085), no 11q LOH (84.8% vs. 70.9% if 11q LOH; p = 0.0004) and high mitosis-karyorrhexis index (MKI; 84.5% vs. 77.5% if low-intermediate MKI; p = 0.0098). On multivariable analysis (n = 407), the absence of 11q LOH was the only factor that remained significantly associated with ≥PR (odds ratio: 1.962 vs. 11q LOH; 95% confidence interval 1.104-3.487; p = 0.0216). CONCLUSIONS: Improved end-induction response in high-risk neuroblastoma is associated with longer survival. Patients with 11q LOH are less likely to respond to induction therapies and should be prioritised for novel approaches in future trials.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Eur J Cancer

DOI

EISSN

1879-0852

Publication Date

May 2019

Volume

112

Start / End Page

66 / 79

Location

England

Related Subject Headings

  • Risk Factors
  • Prognosis
  • Oncology & Carcinogenesis
  • Nuclear Proteins
  • Neuroblastoma
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • N-Myc Proto-Oncogene Protein
  • Male
  • Loss of Heterozygosity
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Pinto, N., Naranjo, A., Hibbitts, E., Kreissman, S. G., Granger, M. M., Irwin, M. S., … DuBois, S. G. (2019). Predictors of differential response to induction therapy in high-risk neuroblastoma: A report from the Children's Oncology Group (COG). Eur J Cancer, 112, 66–79. https://doi.org/10.1016/j.ejca.2019.02.003
Pinto, Navin, Arlene Naranjo, Emily Hibbitts, Susan G. Kreissman, M Meaghan Granger, Meredith S. Irwin, Rochelle Bagatell, et al. “Predictors of differential response to induction therapy in high-risk neuroblastoma: A report from the Children's Oncology Group (COG).Eur J Cancer 112 (May 2019): 66–79. https://doi.org/10.1016/j.ejca.2019.02.003.
Pinto N, Naranjo A, Hibbitts E, Kreissman SG, Granger MM, Irwin MS, et al. Predictors of differential response to induction therapy in high-risk neuroblastoma: A report from the Children's Oncology Group (COG). Eur J Cancer. 2019 May;112:66–79.
Pinto, Navin, et al. “Predictors of differential response to induction therapy in high-risk neuroblastoma: A report from the Children's Oncology Group (COG).Eur J Cancer, vol. 112, May 2019, pp. 66–79. Pubmed, doi:10.1016/j.ejca.2019.02.003.
Pinto N, Naranjo A, Hibbitts E, Kreissman SG, Granger MM, Irwin MS, Bagatell R, London WB, Greengard EG, Park JR, DuBois SG. Predictors of differential response to induction therapy in high-risk neuroblastoma: A report from the Children's Oncology Group (COG). Eur J Cancer. 2019 May;112:66–79.
Journal cover image

Published In

Eur J Cancer

DOI

EISSN

1879-0852

Publication Date

May 2019

Volume

112

Start / End Page

66 / 79

Location

England

Related Subject Headings

  • Risk Factors
  • Prognosis
  • Oncology & Carcinogenesis
  • Nuclear Proteins
  • Neuroblastoma
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • N-Myc Proto-Oncogene Protein
  • Male
  • Loss of Heterozygosity