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Neuroblastoma is the most typical extracranial stable tumor in youngsters, with practically 50% of circumstances recognized at a sophisticated stage, usually with metastatic illness. Regardless of advances in therapy, survival charges for high-risk and relapsed/refractory neuroblastoma stay dismal, and choices like autologous stem cell transplantation and immunotherapy are often unavailable in low- and middle-income nations.
Given these stark realities, there’s a essential want for different, extra accessible therapies like metronomic chemotherapy (MC) to enhance survival prospects for these youngsters.
A workforce of researchers from the Youngsters’s Hospital of Chongqing Medical College has revealed a complete assessment in Pediatric Discovery, detailing the potential of MC in treating pediatric neuroblastoma. The examine supplies an in-depth examination of MC’s efficacy, security, and its potential function as a upkeep remedy and in relapsed/refractory settings, providing new hope for youngsters in determined want of efficient therapies.
The assessment examines the mechanics of MC as a therapeutic technique, emphasizing its potential to keep up sustained drug ranges over prolonged intervals with diminished toxicity. Not like typical high-dose chemotherapy regimens, MC makes use of low-dose brokers like cyclophosphamide and etoposide, usually together with non-chemotherapeutic brokers corresponding to celecoxib and thalidomide.
Early research have reported promising outcomes, with illness management charges reaching as much as 45%, notably in high-risk sufferers. Certainly one of MC’s most outstanding options is its efficacy in resource-limited areas, the place entry to superior therapies corresponding to autologous stem cell transplantation or immunotherapy is usually unavailable.
The assessment additionally highlights a rising pattern in combining MC with immunotherapy and focused therapies like nivolumab and pazopanib to boost its therapeutic results. Nonetheless, regardless of these encouraging findings, variability in drug mixtures, dosages, and therapy schedules throughout research has hindered the institution of standardized protocols. Figuring out predictive biomarkers and optimizing therapy regimens stay important to unlocking MC’s full potential.
The authors underscore the significance of continued analysis to fine-tune MC protocols.
“While MC has shown significant promise in improving survival and quality of life for pediatric neuroblastoma patients, further studies are necessary to identify the most effective drug combinations and biomarkers that predict response to treatment,” they write.
They name for additional investigation into MC’s optimization that displays the necessity for a deeper understanding of how this revolutionary therapy can greatest serve younger sufferers.
The applying of MC in pediatric neuroblastoma holds immense promise, particularly in resource-limited areas the place entry to superior therapies is restricted. MC’s low-toxicity profile, ease of outpatient administration, and cost-effectiveness place it as a extremely engaging different to conventional high-intensity therapies. As a upkeep remedy and in palliative care, it gives new hope for improved outcomes.
Integrating MC with rising immunotherapies and focused therapies supplies a chance to additional improve its effectiveness. Transferring ahead, the event of standardized protocols and the identification of biomarkers to information personalised therapy methods shall be essential to optimizing MC’s influence, making it a cornerstone in each newly recognized and relapsed/refractory neuroblastoma administration worldwide.
Extra data:
Yi Jiang et al, Metronomic chemotherapy in pediatric neuroblastoma, Pediatric Discovery (2024). DOI: 10.1002/pdi3.2512
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Metronomic chemotherapy: A promising method for pediatric neuroblastoma (2025, January 23)
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