Neuroblastoma: Current Imaging and Therapeutics

Neuroblastoma is the most common solid abdominal tumor in children under the age of 2 years and accounts for approximately 15% of childhood mortality due to cancer. Its clinical behavior can vary from spontaneous regression to rapid fatal progression and anywhere in between (e.g. differentiation into benign tumors). Unfortunately, 50% of patients already have metastases at presentation. This marked clinical variability and often advanced presentation at time of diagnosis must be addressed with improved imaging and new treatments, particularly through focus on expanded drug development. Current treatment regimens (surgical resection, chemotherapy, and radiotherapy) have proven to be inadequate for treating advanced disease and frequently cause severe side effects that make them intolerable for many children. Promising new therapies include anti-adhesion therapy and immunotherapy, which uses antibodies to trigger a patient’s own immune system to destroy neuroblastoma cells. Of particular interest in the realm of anti-adhesion is attenuation of NF-κB over-activation. Increased NF-κB activity is thought to play a role in the development of tumor resistance to chemotherapeutic agents and radiation. Therefore, novel drugs to attenuate NF-kB activity could revolutionize treatment by increasing overall treatment effectiveness and allowing for reduced drug and radiation doses for dose-sensitive patients.