Follow-up in Neuroblastoma: Comparison of Metaiodobenzylguanidine and a Chimeric Anti-GD2 Antibody for Detection of Tumor Relapse and Therapy Response

Abstract

Early and correct diagnosis of local tumor recurrence, occurrence of metastases, and therapy response are essential in patients with neuroblastoma stage IV. The aim of the study was to evaluate the diagnostic value of metaiodobenzylguanidine (mIBG) and a chimeric GD2 antibody in the follow-up of patients with neuroblastoma. In a prospective study, mIBG (N = 31 scans) and immunoscintigraphy were compared with a chimeric antiganglioside antibody, ch14.18 (MAb) (N = 31 scans), labeled with technetium Tc 99m in the follow-up of 18 patients with stage IV neuroblastoma. The findings were compared with histologic findings, other imaging examinations, and clinical changes over the course of 4 to 6 years. For the diagnosis of local tumor recurrences, sensitivity was 80% for MAb and 70% for mIBG. Specificity was 93% for MAb and 72% for mIBG. The MAb was superior for the detection of skeletal metastases, with a sensitivity of 82% compared with 72% for mIBG. Specificity was 100% for both techniques. Also, for soft tissue/lymph node metastases, sensitivity for MAb was higher (50%) than for mIBG (31%). Specificity was 100% for each technique. In sequential studies, metastases were detected earlier with MAb (mean: 2.3 m for skeletal metastases, 3.6 m for soft tissue metastases) than with mIBG. After therapy, tumor uptake was visualized longer with mIBG (mean 6.3 m) than with MAb. The chimeric antibody ch14.18 is likely to be valuable for follow-up examinations and for assessment of therapy response because of earlier detection of new metastases.

Selection of novel peptide mimics of the GD2 ganglioside from a constrained phage-displayed peptide library

“…Overexpression of GD2 ganglioside distinguishes neuroblastoma from benign neural tumors (11), which has resulted in the application of antibodies targeting the carbohydrate in the diagnosis of localized and metastatic neuroblastoma and in the monitoring of therapy response and minimal residual disease (12,13). The fact that approximately 60% of children with neuroblastoma, which is the most common extracranial neoplasm of childhood, have high-risk tumors that can rarely be cured by conventional therapy, stresses the need for new treatment protocols to control minimal residual disease.…”

Anti-GD2 MABS and Next-Generation mAb-Based Agents for Cancer Therapy

“…131 I-3F8 was sensitive and specific at detecting sites with metastatic disease as shown by CT/MRI, and identifying tumors that were confirmed histologically as NBLs [114]. Likewise, 99 Tc-14.18 demonstrated superior sensitivity in the detection of tumor recurrence and metastases when compared with metaiodobenzylguanidine, demonstrating the value of these reagents for the assessment of therapy response, disease progression and early detection of metastases [115].…”

NK cell depletion diminish tumour-specific B cell responses

“…GD2 ganglioside is a tumour associated antigen highly overexpressed on IMR5-75 cells [16]. Clinically, GD2 has importance in immunodiagnostics and specific antibody therapy in neuroblastoma [16].…”