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    Home > Active Ingredient News > Antitumor Therapy > Focusing on the progress of diagnosis and treatment of neuroblastoma, focusing on the landing of targeted immunotherapy-"Neuroblastoma Targeted Immunity Frontier Forum" conference report

    Focusing on the progress of diagnosis and treatment of neuroblastoma, focusing on the landing of targeted immunotherapy-"Neuroblastoma Targeted Immunity Frontier Forum" conference report

    • Last Update: 2022-01-09
    • Source: Internet
    • Author: User
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    The "Neuroblastoma Targeted Immunity Frontier Forum" sponsored by China Medical and Health Development Foundation and co-organized by Saisheng Pharmaceutical Holdings Co.
    , Ltd.
    was successfully held on December 22, 2021
    .

    More than 60 top medical experts from more than 20 hospitals in China, Hong Kong, China, and Spain gathered online to conduct in-depth discussions
    .

    Professor Dong Kunran and Professor Zhai Xiaowen from the Children's Hospital of Fudan University, and Professor Wu Yeming from Xinhua Hospital, Shanghai Jiaotong University School of Medicine, co-chaired the meeting and organized discussions
    .

     Professor Xiaowen Zhai of the Children's Hospital of Fudan University stated in his opening speech that 2021 will be a special year for domestic high-risk patients with goddesses, because two GD2 targeted immunotherapy drugs have been introduced into China
    .

    In August of this year, the Children's Hospital of Fudan University, Hainan Women and Children's Medical Center, and Boao Future Hospital jointly completed the first infusion of Nacituzumab in the Boao Pilot Area
    .

    At the "Neuroblastoma Targeted Immunity Frontier Forum", we will not only share the experience of using natalizumab in China, but also have domestic and foreign experts sharing the latest progress in disease diagnosis and treatment.
    We hope that all experts will express their opinions and speak freely
    .

    The first part of the conference was chaired by Professor Wu Yeming from Xinhua Hospital, Shanghai Jiaotong University School of Medicine, focusing on the current status and latest developments in the diagnosis and treatment of neuroblastoma at home and abroad
    .

    Professor Chen Zhifeng: Different medication regimens based on GD2 monoclonal antibody have shown advantages in different patients.
    Whether transplantation benefits remains to be explored.
    Professor Chen Zhifeng from Hong Kong Children's Hospital first gave a keynote report on "Neuroblastoma treatment progress" and shared the neuroma The latest developments in cell tumor risk stratification, comparison of chemotherapy regimens, and immunotherapy
    .

    First, Professor Chen Zhifeng introduced the latest revised neuroblastoma risk classification system.
    The new risk stratification method adds segmental sex chromosomal abnormalities (SCA) status (such as 1p deletion and 11q weight) to the original DNA index.
    Platoon), so as to better distinguish between low- and medium-risk groups
    .

    In terms of chemotherapy, different chemotherapy regimens still use similar drug combinations, and there is no evidence to prove which chemotherapy regimen is the best
    .

    In terms of immunotherapy, GD2 antibody drugs have been shown to improve the prognosis of patients with high-risk god mothers.
    At the same time, new drug regimens based on GD2 antibodies have also had preliminary results.
    For example, combined chemotherapy has a significant effect on patients with soft tissue metastases
    .

    At present, one of the difficulties in the treatment of goddess is still central system metastasis or recurrence, but some preliminary research results suggest that the use of 131I-8H9 or 131I-3F8) can improve the prognosis
    .

    In addition, transplantation is still one of the hot spots of neuroblastoma, and the effectiveness and safety of tandem transplantation, allotransplantation and haploid hematopoietic stem cell transplantation still need to be verified
    .

    In the field of immunotherapy, tumor vaccines and bispecific antibodies may be useful tools for future therapy of the goddess.
    However, the relevant clinical research on CAR-T therapy and molecular targeted therapy has not yet obtained satisfactory results, and it is still necessary to focus on key targets.
    Evaluation and improvement
    .

    Professor Su Yan: The introduction of GD2 antibody makes up for the shortcomings of domestic high-risk immunotherapy of the mothers.
    Bone/marrow/central metastasis and refractory/relapsed mothers are still difficult to treat To sort out and give a theme report on "The current status and treatment difficulties of high-risk neuroblastoma in China"
    .

    First, the proportion of high-risk patients with neuroblastoma in China is as high as 54.
    7%, and the 5-year EFS and OS are 37.
    7% and 48.
    9%, and 49.
    3% of the patients have tumor recurrence or progression
    .

    In addition, a number of studies have further explored that patients with high risk of bone marrow/bone metastasis have a higher rate of disease progression or recurrence and a worse prognosis
    .

    For the treatment of high-risk god mothers, the overall treatment path at home and abroad is the same, that is, induction therapy, consolidation therapy and maintenance therapy
    .

    The introduction of GD2 antibody therapy into China also makes up for the shortcomings of domestic high-risk immunotherapy
    .

    In addition, the degree of surgical resection, the timing of radiotherapy, whether MIBG and other radionuclide treatments, hematopoietic stem cell transplantation, CART and other treatments can benefit patients with neuroblastoma have different results, and further exploration is needed
    .

    Summarizing the research data and clinical practice, bone marrow metastasis with minimal residual disease, bone metastasis, central metastasis, refractory/relapsed mothers are still difficult points in the treatment of high-risk mothers, and we look forward to more exploration
    .

    The second part of the conference was chaired by Professor Dong Kuoran from the Pediatric Hospital of Fudan University to share and discuss the treatment experience of nasetuzumab at home and abroad
    .

     Dr.
    Mora: Narcituzumab has a definite effect in the treatment of high-risk malignant mothers with bone/marrow metastasis.
    The combination of chemotherapy for patients with soft tissue metastasis is beginning to see light.
    Whether or not receiving stem cell transplantation does not affect the therapeutic effect, Professor Dr.
    Mora from the Sant Joan de Deu Hospital in Barcelona, ​​Spain "The application and progress of Nacituzumab in neuroblastoma" gave a keynote report
    .

    Dr.
    Mora first shared the development and clinical exploration of the "predecessor" of natalizumab (humanized 3F8, or HU3F8), the first generation of GD2 antibody, and murine 3F8 or MU3F8
    .

    MU3F8 has been explored for 25 years.
    A number of clinical studies have shown that it can bring significant benefits to patients with high-risk neuroblastoma such as primary refractory, first remission, and second remission
    .

    Based on the establishment of efficacy, research and development in two aspects, optimizing antibody structure and exploring drug combinations, opened the era of the second generation of GD2 targeted immunotherapy
    .

    Narcetuzumab (HU3F8) is the world's first approved humanized anti-GD2 monoclonal antibody.
    The optimization of the structure brings higher tumor affinity and higher doses than other GD2 antibodies
    .

    Nacituzumab-based immunotherapy has been explored in different high-risk patient groups
    .

    The 201 registration study showed that for primary refractory/relapsed refractory high-risk patients, the ORR of treatment with nasetuzumab combined with GM-CSF can reach 68%
    .

    Another study showed that patients with high-risk mothers in complete remission who received natalizumab combined with GM-CSF had a 2-year OS of 90.
    6%, and the 3-year OS of patients with first CR was as high as 91.
    6%
    .

    The results of another study showed that whether to accept autologous stem cell transplantation does not affect the therapeutic effect of natalizumab
    .

    For patients with high-risk mothers with soft tissue metastasis, narcetuzumab + GM-CSF + chemotherapy has shown a good effect, and 41.
    5% of patients received disease remission after only 2 courses of treatment
    .

    The exploration of targeted immunotherapy for high-risk goddesses continues, including anti-GD2 vaccines and 131I-8H9 for central metastasis, which are expected to bring benefits to more patients
    .

    In summary, GD2 targeted immunotherapy should not be a "passive" choice.
    Narcetuzumab and the combination of antibodies and new drugs under development will bring more neuroblastoma patients with the possibility of cure
    .

     Professor Qian Xiaowen, Chen Weiming, and Zhuang Peijun from the Pediatric Hospital of Fudan University: 14 patients have completed 103 nasetuzumab infusions.
    The infusion reaction was controllable and all disappeared within 4 hours.
    Early evaluation of patients has shown the disease Relieve the team from the Children's Hospital of Fudan University reported on the "Nacituzumab diagnosis and treatment experience in Boao Pioneer District"
    .

    Nacituzumab was approved by the U.
    S.
    Food and Drug Administration in November 2020 to be administered in combination with GM-CSF for patients with bone or bone marrow lesions, and showed partial remission, mild remission or stable disease to previous treatments Of children 1 year and older or adults with recurrent or refractory high-risk neuroblastoma
    .

    Narcetumab was introduced to China this year, led by Fudan Pediatrics and under the cooperation of multiple parties, it took 5 months to complete the first patient's successful medication on August 7
    .

    As of December 20, we have completed 103 infusions in 14 patients.
    We are very happy to see that MIBG examinations after 2 courses of treatment showed very good disease relief
    .

    Due to the characteristics of natalizumab immunotherapy, most of the adverse reactions only occur during infusion, and the more common ones are pain and hypotension
    .

    It should be emphasized that these adverse reactions are controllable, and all patients can be completely relieved within 4 hours of the end of the infusion, and there is no need to extend the hospital stay due to adverse reactions
    .

    After a patient finished the infusion at noon, he went to the beach to play in the afternoon
    .

    Narcetuzumab is infused in an outpatient setting abroad.
    I believe that under the management of a medication team with relatively rich experience in medication, in the future, it may also be possible to try outpatient infusion of narctuzumab in China
    .

     Finally, Professor Dong Kunran from the Pediatric Hospital of Fudan University made a summary of the meeting
    .

    Professor Dong Kuoran expressed his gratitude to all the experts for participating and active discussions
    .

    As far as the Pediatric Hospital of Fudan University is concerned, based on previous experience, the infusion reaction of narcetuomab only occurs during the infusion and can be quickly recovered after the end of the medication.
    It can be guaranteed by the experienced MDT team.
    The infusion was successfully completed
    .

    We also hope that with the joint efforts of all the experts, we will make good use of the new medicine and work out a Chinese plan to provide the best treatment for Chinese children
    .

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