Neuroblastoma Treatment

Chemotherapy is a form of neuroblastoma treatment that aims to destroy cancer cells by targeting rapidly growing cells. Unfortunately, this mechanism for destroying cancer cells often damages healthy cells growing quickly, leaving unwanted side effects such as hair loss and damage to the gastrointestinal system.

Chemotherapy treatment for neuroblastoma will depend on your child’s risk group. Some children may not be treated with chemotherapy at all, others may be treated before or after surgery, and some may be given chemotherapy as the main form of treatment. In many cases, children with intermediate-high-risk neuroblastoma will receive a combination of chemotherapy drugs prior to undergoing surgery to shrink the tumor and improve the probability of successfully removing the tumor. Chemotherapy is also frequently used prior to bone marrow transplant.

If your child’s treatment plan does include chemotherapy, the specific chemotherapy treatment, or combination of treatments, will be chosen after carefully evaluating your child’s case and determining the most effective for your child’s treatment.

At Sheba, we ensure that each patient is closely monitored following the administration of chemotherapy drugs in order to adjust or change medications based on the patient’s needs and response to treatment.

Targeted therapy drugs, often referred to as biological treatment, just like chemotherapy, treat patients by destroying cancer cells; however, unlike regular chemotherapy, targeted therapy works by identifying specific cancer cells while sparing healthy cells. As a result of healthy cells being avoided, patients don’t suffer from some of the harsh side effects of chemotherapy. In some cases, targeted therapies are more effective than chemotherapy drugs.

There are many different kinds of targeted therapy drugs, each working differently. Certain types of treatments work by blocking chemical signals that tell cancer cells to grow, while others change proteins within the cancer cells, causing them to die. Some treatments prevent new blood vessels from forming, removing the blood supply to cancer cells and destroying them, and other treatments trigger the immune system to kill cancer cells or cause toxins to be brought to cancer cells which kill them.

Targeted therapy can be used alone, but it is more often used in conjunction with other cancer treatments, such as chemotherapy, radiation, and surgery. As cancer treatment research continues and advances, new and better-targeted therapies are being engineered continuously. At Sheba, our skilled scientists and oncologists are leading the way in the clinical application of cutting-edge targeted therapies.

Radiation therapy uses high doses of radiation, such as X-rays and other forms of radiation, to destroy cancer cells. In the case of neuroblastoma, radiation is usually administered after surgery to eradicate any remaining cancer cells or to shrink tumors before surgical removal. It may also be used in combination with chemotherapy to increase the chances of a successful outcome. Radiation therapy for neuroblastoma is carefully planned and administered by a team of medical professionals, taking into account the specific needs and circumstances of each patient.

Radiation therapy affects mainly the area where it’s aimed; however, in many cases, healthy cells can be damaged from the treatment. The side effects of the treatment depend greatly on the area of the radiation and the amount that has been administered. The goal of radiation therapy in neuroblastoma treatment is to effectively eliminate cancer cells while minimizing damage to surrounding healthy tissues and organs, thereby improving the chances of long-term survival and minimizing potential side effects.

In many cases, doctors will try to avoid this form of treatment in young children due to its long-term side effects. However, if a child is considered high-risk or if they have life-threatening symptoms, it may be used regardless of the risks it poses.

Operating on Neuroblastoma in surgery is an intricate procedure that aims to remove the tumor and potentially eliminate cancer cells. The extent of surgical intervention depends on the risk category of the neuroblastoma.

In low-risk cases, surgery alone may be sufficient, aiming to excise the tumor completely. However, for intermediate-risk and high-risk neuroblastoma, surgeons strive to remove as much of the tumor as possible, followed by complementary treatments such as chemotherapy and radiation therapy to target any remaining cancer cells.

The surgical approach is carefully tailored to the specific location and size of the tumor, taking into account the proximity to vital organs and the potential risks involved. At Sheba, collaboration between surgeons, oncologists, and the multidisciplinary medical team is essential to optimize the surgical outcome and overall treatment success for neuroblastoma patients.

Immunotherapy has emerged as a promising treatment approach for neuroblastoma, with this innovative therapy harnessing the power of the immune system to target and destroy cancer cells.

In the case of neuroblastoma, immunotherapy often involves the use of antibodies or immune checkpoint inhibitors. Antibodies can be designed to specifically recognize and bind to certain proteins on neuroblastoma cells, marking them for destruction by immune cells. Immune checkpoint inhibitors, on the other hand, help unleash the immune system’s full potential by blocking the signals that cancer cells use to evade detection and attack.

Immunotherapy has shown remarkable success, particularly in high-risk and relapsed cases of neuroblastoma, providing new hope and improved outcomes for patients. Ongoing research and clinical trials continue to explore and refine the use of immunotherapy in the treatment of neuroblastoma, with the aim of further enhancing its effectiveness and reducing potential side effects.

This procedure involves the replacement of diseased or damaged bone marrow with healthy stem cells. Bone marrow transplants are usually performed in high-risk or relapsed cases where the cancer has spread or become resistant to other treatments.

Prior to receiving the transplant, the patient typically undergoes chemotherapy or surgery, or a combination of both, to remove cancer cells and suppress the immune system. In most cases, children with neuroblastoma receive their own stem cells for the transplant. Before the stem cell transplant is performed, the child is given medication that promotes the production of white blood cells and encourages stem cells to move into the bloodstream. The stem cells are then removed from the blood and frozen until the transplant. When it is time for the transplant, the stem cells are thawed and given to the patient through a blood transfusion, where they migrate to the bone marrow and begin producing new blood cells.

The transplanted stem cells help restore the immune system and replenish the blood cell supply. Stem cell transplant can offer a chance for long-term remission or cure in selected cases of neuroblastoma, although the procedure carries potential risks and complications. The decision to undergo a stem cell transplant is made after careful evaluation and consideration by a multidisciplinary medical team, taking into account various factors such as the patient’s overall health, disease status and available treatment options.

CAR-T cell therapy has emerged as a promising and innovative approach in the treatment of neuroblastoma. This therapy involves modifying a patient’s own immune cells, specifically T cells, to express chimeric antigen receptors (CARs) that target neuroblastoma cells. The modified CAR T-cells are then infused back into the patient, where they recognize and bind to specific proteins on the surface of neuroblastoma cells, leading to their destruction.

CAR T-cell therapy offers the potential for precise and targeted treatment, especially for high-risk and relapsed neuroblastoma cases that are often challenging to treat with conventional approaches. While further research and clinical trials are ongoing to optimize CAR T-cell therapy for neuroblastoma, early results have shown promising responses and durable remissions, providing renewed hope for patients and their families.