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Treatment-Related Toxicities During Anti-GD2 Immunotherapy in High-Risk Neuroblastoma Patients
The introduction of immunotherapy using an anti-GD2 antibody (dinutuximab, ch14.18) has significantly improved survival rates for high-risk neuroblastoma patients. However, this improvement in survival is accompanied by a substantial immunotherapy-related toxicity burden. The primary objective of th...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925836/ https://www.ncbi.nlm.nih.gov/pubmed/33680926 http://dx.doi.org/10.3389/fonc.2020.601076 |
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author | Blom, Thomas Lurvink, Roosmarijn Aleven, Leonie Mensink, Maarten Wolfs, Tom Dierselhuis, Miranda van Eijkelenburg, Natasha Kraal, Kathelijne van Noesel, Max van Grotel, Martine Tytgat, Godelieve |
author_facet | Blom, Thomas Lurvink, Roosmarijn Aleven, Leonie Mensink, Maarten Wolfs, Tom Dierselhuis, Miranda van Eijkelenburg, Natasha Kraal, Kathelijne van Noesel, Max van Grotel, Martine Tytgat, Godelieve |
author_sort | Blom, Thomas |
collection | PubMed |
description | The introduction of immunotherapy using an anti-GD2 antibody (dinutuximab, ch14.18) has significantly improved survival rates for high-risk neuroblastoma patients. However, this improvement in survival is accompanied by a substantial immunotherapy-related toxicity burden. The primary objective of this study was to describe treatment-related toxicities during immunotherapy with dinutuximab, IL-2, GM-CSF, and isotretinoin. A retrospective, single center analysis of immunotherapy-related toxicities was performed in twenty-six consecutive high-risk neuroblastoma patients who received immunotherapy as maintenance therapy in the Princess Máxima Center (Utrecht, Netherlands). Toxicities were recorded and graded according to the CTCAE. Particular attention was drawn to pain and fever management and toxicities leading to dose modifications of dinutuximab and IL-2. Twenty-three patients (88%) completed all six courses of immunotherapy. Disease progression, isotretinoin-associated liver toxicity, and catheter-related infection in combination with peripheral neuropathy were reasons for immunotherapy discontinuation. The most common grade ≥3 toxicities for courses 1–5, respectively, were pain, catheter-related infections, and fever. In total, 310 grade ≥3 toxicities were recorded in 124 courses. Thirty-three grade 4 toxicities in 19/26 patients and no grade 5 toxicities (death) were seen. Fifty-nine percent of grade ≥3 toxicities were recorded in the two courses with IL-2. Catheter-related bloodstream infections were identified in 81% of patients. Four of these episodes led to intensive care admission followed by full recovery (grade 4). |
format | Online Article Text |
id | pubmed-7925836 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79258362021-03-04 Treatment-Related Toxicities During Anti-GD2 Immunotherapy in High-Risk Neuroblastoma Patients Blom, Thomas Lurvink, Roosmarijn Aleven, Leonie Mensink, Maarten Wolfs, Tom Dierselhuis, Miranda van Eijkelenburg, Natasha Kraal, Kathelijne van Noesel, Max van Grotel, Martine Tytgat, Godelieve Front Oncol Oncology The introduction of immunotherapy using an anti-GD2 antibody (dinutuximab, ch14.18) has significantly improved survival rates for high-risk neuroblastoma patients. However, this improvement in survival is accompanied by a substantial immunotherapy-related toxicity burden. The primary objective of this study was to describe treatment-related toxicities during immunotherapy with dinutuximab, IL-2, GM-CSF, and isotretinoin. A retrospective, single center analysis of immunotherapy-related toxicities was performed in twenty-six consecutive high-risk neuroblastoma patients who received immunotherapy as maintenance therapy in the Princess Máxima Center (Utrecht, Netherlands). Toxicities were recorded and graded according to the CTCAE. Particular attention was drawn to pain and fever management and toxicities leading to dose modifications of dinutuximab and IL-2. Twenty-three patients (88%) completed all six courses of immunotherapy. Disease progression, isotretinoin-associated liver toxicity, and catheter-related infection in combination with peripheral neuropathy were reasons for immunotherapy discontinuation. The most common grade ≥3 toxicities for courses 1–5, respectively, were pain, catheter-related infections, and fever. In total, 310 grade ≥3 toxicities were recorded in 124 courses. Thirty-three grade 4 toxicities in 19/26 patients and no grade 5 toxicities (death) were seen. Fifty-nine percent of grade ≥3 toxicities were recorded in the two courses with IL-2. Catheter-related bloodstream infections were identified in 81% of patients. Four of these episodes led to intensive care admission followed by full recovery (grade 4). Frontiers Media S.A. 2021-02-17 /pmc/articles/PMC7925836/ /pubmed/33680926 http://dx.doi.org/10.3389/fonc.2020.601076 Text en Copyright © 2021 Blom, Lurvink, Aleven, Mensink, Wolfs, Dierselhuis, van Eijkelenburg, Kraal, van Noesel, van Grotel and Tytgat http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Blom, Thomas Lurvink, Roosmarijn Aleven, Leonie Mensink, Maarten Wolfs, Tom Dierselhuis, Miranda van Eijkelenburg, Natasha Kraal, Kathelijne van Noesel, Max van Grotel, Martine Tytgat, Godelieve Treatment-Related Toxicities During Anti-GD2 Immunotherapy in High-Risk Neuroblastoma Patients |
title | Treatment-Related Toxicities During Anti-GD2 Immunotherapy in High-Risk Neuroblastoma Patients |
title_full | Treatment-Related Toxicities During Anti-GD2 Immunotherapy in High-Risk Neuroblastoma Patients |
title_fullStr | Treatment-Related Toxicities During Anti-GD2 Immunotherapy in High-Risk Neuroblastoma Patients |
title_full_unstemmed | Treatment-Related Toxicities During Anti-GD2 Immunotherapy in High-Risk Neuroblastoma Patients |
title_short | Treatment-Related Toxicities During Anti-GD2 Immunotherapy in High-Risk Neuroblastoma Patients |
title_sort | treatment-related toxicities during anti-gd2 immunotherapy in high-risk neuroblastoma patients |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925836/ https://www.ncbi.nlm.nih.gov/pubmed/33680926 http://dx.doi.org/10.3389/fonc.2020.601076 |
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