Impact of MYCN Status on Response of High-Risk Neuroblastoma to Neoadjuvant Chemotherapy
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In brief
In brief
Retrospective study of 84 high-risk neuroblastoma patients demonstrates that MYCN-amplified tumors show significantly greater volume reduction with neoadjuvant chemotherapy (72% vs 47%) compared to non-amplified tumors, though this enhanced primary tumor response did not translate to improved metastatic disease control or surgical resectability rates.
Written by the GCMD Library team from the article.
Background/Purpose
MYCN-amplification in neuroblastoma is associated with an aggressive clinical phenotype. We evaluated the association of MYCN amplification with tumor response to neoadjuvant chemotherapy.
Methods
Primary tumor response, assessed by percentage volume change on CT scan and degree of tumor resection, assessed by the operating surgeon, were retrospectively compared in 84 high-risk neuroblastoma patients. There were thirty-four (40%) with MYCN-amplified tumors and fifty (60%) with non-amplified tumors treated at our institution from 1999 to 2016. Metastatic disease response was assessed on MIBG scan by change in Curie score.
Results
MYCN-amplification was associated with a greater mean percentage reduction in primary tumor volume after neoadjuvant chemotherapy (72.27% versus 46.83% [non-amplified tumors], p = 0.001). The percentage of patients with a Curie score > 2 at diagnosis who then had a score ≤ 2 after neoadjuvant chemotherapy was not significantly different (8 [61.5%] and 8 [34.8%], respectively, p = 0.37). Twenty-eight (85.7%) patients with MYCN-amplification had ≥90% surgical resection compared to 45 (91.84%) patients with non-amplified tumors (p = 0.303).
Conclusions
MYCN-amplification in high-risk neuroblastoma was associated with a better response of the primary tumor to neoadjuvant chemotherapy, but not metastatic sites, than in patients with non-amplified tumors. This did not significantly impact the ability to resect ≥90% of the primary tumor/locoregional disease.
Type of Study
Treatment Study
Level of Evidence
Level III