Efficacy of Temozolomide in Children with Solid Tumors

Ariano, Anna; Attinà, Giorgio; Triarico, Silvia; Coccia, Paola; Capozza, Michele Antonio; Maurizi, Palma; Ruggiero, Antonio

doi:10.13005/bpj/1901

Cited by 2 publications

(1 citation statement)

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“…The treatment strategy for high-risk neuroblastoma patients includes induction chemotherapy, surgery, consolidation with myeloablative high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (SCT), and maintenance therapy. Better tumor responses after induction therapy appear to be critical to improve the percentage of long-term survival, but the dose intensity of traditional drugs such as platin compounds, cyclophosphamide, etoposide, doxorubicin, vincristine, topotecan, and temozolomide cannot be increased because of their hematological and non-hematological toxicities [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Moreover, some new combinations of agents active against neuroblastoma have been developed with encouraging results, but none of them have yet been adopted in large randomized trials [ 14 , 15 , 16 ].…”

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confidence: 99%

Mechanisms, Characteristics, and Treatment of Neuropathic Pain and Peripheral Neuropathy Associated with Dinutuximab in Neuroblastoma Patients

Rivetti

Triarico

Romano

et al. 2021

IJMS

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Prognosis of metastatic neuroblastoma is very poor. Its treatment includes induction chemotherapy, surgery, high-dose chemotherapy, radiotherapy, and maintenance with retinoic acid, associated with the anti-GD2 monoclonal antibody (ch14.18) dinutuximab. Immunotherapy determined a significant improvement in survival rate and is also utilized in relapsed and resistant neuroblastoma patients. Five courses of dinutuximab 100 mg/m2 are usually administered as a 10-day continuous infusion or over 5 consecutive days every 5 weeks. Dinutuximab targets the disialoganglioside GD2, which is highly expressed on neuroblastoma cells and minimally present on the surface of normal human neurons, peripheral pain fibers, and skin melanocytes. Anti GD2 antibodies bind to surface GD2 and determine the lysis of neuroblastoma cells induced by immune response via the antibody-dependent cellular cytotoxicity and the complement-dependent cytotoxicity. Dinutuximab has significant side effects, including neuropathic pain, peripheral neuropathy, hypersensitivity reactions, capillary leak syndrome, photophobia, and hypotension. The most important side effect is neuropathic pain, which is triggered by the same antibody–antigen immune response, but generates ectopic activity in axons, which results in hyperalgesia and spontaneous pain. Pain can be severe especially in the first courses of dinutuximab infusion, and requires the administration of gabapentin and continuous morphine infusion. This paper will focus on the incidence, mechanisms, characteristics, and treatment of neuropathic pain and peripheral neuropathy due to dinutuximab administration in neuroblastoma patients.

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