Open Access
ARTICLE
Excellent Early Outcomes of Combined Chemotherapy With Arsenic Trioxide for Stage 4/M Neuroblastoma in Children: A Multicenter Nonrandomized Controlled Trial
Chunmou Li*1, Xiaomin Peng*1, Chuchu Feng*1, Xilin Xiong*, Jianxin Li†, Ning Liao‡, Zhen Yang§, Aiguo Liu¶, Pingping Wu*, Xuehong Liang†, Yunyan He‡, Xin Tian§, Yunbi Lin§, Songmi Wang¶, Yang Li*
* Pediatric Hematology/Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, P.R. China
† Department of Hematology and Oncology, Wuhan Children’s Hospital, Tongji Medical College,
Huazhong University of Science & Technology, Wuhan, P.R. China
‡ Department of Pediatrics, The First Affiliated Hospital of GuangXi Medical University, Nanning, P.R. China
§ Department of Hematology, Kunming Children’s Hospital, Kunming, P.R. China
¶ Department of Pediatric Hematology & Oncology, Tongji Medical College, Huazhong University of Science & Technology,
Wuhan, P.R. China
Oncology Research 2020, 28(7-8), 791-800. https://doi.org/10.3727/096504021X16184815905096
Abstract
This nonrandomized, multicenter cohort, open-label clinical trial evaluated the efficacy and safety of combined
chemotherapy with arsenic trioxide (ATO) in children with stage 4/M neuroblastoma (NB). We enrolled patients
who were newly diagnosed with NB and assessed as stage 4/M and received either traditional chemotherapy
or ATO combined with chemotherapy according to their own wishes. Twenty-two patients were enrolled in
the trial group (ATO combined with chemotherapy), and 13 patients were enrolled in the control group (traditional chemotherapy). Objective response rate (ORR) at 4 weeks after completing induction chemotherapy was
defined as the main outcome, and adverse events were monitored and graded in the meantime. Data cutoff date
was December 31, 2019. Finally, we found that patients who received ATO combined with chemotherapy had
a significantly higher response rate than those who were treated with traditional chemotherapy (ORR: 86.36%
vs. 46.16%,
p = 0.020). Reversible cardiotoxicity was just observed in three patients who were treated with
ATO, and no other differential adverse events were observed between the two groups. ATO combined with
chemotherapy can significantly improve end-induction response in high-risk NB, and our novel regimen is well
tolerated in pediatric patients. These results highlight the superiority of chemotherapy with ATO, which creates
new opportunity for prolonging survival. In addition, this treatment protocol minimizes therapeutic costs compared with anti-GD2 therapy, MIBG, and proton therapy and can decrease the burden to families and society.
However, we also need to evaluate more cases to consolidate our conclusion.
Keywords
Cite This Article
Li, C., Peng, X., Feng, C., Xiong, X., Li, J. et al. (2020). Excellent Early Outcomes of Combined Chemotherapy With Arsenic Trioxide for Stage 4/M Neuroblastoma in Children: A Multicenter Nonrandomized Controlled Trial.
Oncology Research, 28(7-8), 791–800.