The CancerWeb Report, What's New In Cancer: February, 1996
Neuroblastoma

• Is chemotherapy always needed? - The authors of a study carried out at Memorial Sloan-Kettering Cancer Center in New York and Vienna, Austria, set out to test the hypothesis that chemotherapy is not needed to assure the survival of most patients who do not have the advanced stage 4 disease. Of 84 patients seen, 31 (37%) had non-stage 4 and also had no amplification of N-myc oncogene a marker of poor prognosis. No stage 1 patients relapsed. Of the 22 patients with locally-invasive or distant disease, two showed spontaneous regression and tumor was excised in four. All patients are alive 24-98 months from diagnosis. Non-stage 4 patients without N-myc amplification can be spared chemotherapy because the disease rarely evolves to lethal stage 4 disease and neuroblastoma in the lymph nodes has no clinical significance. (Kushner, J Clin Oncol 14:373, 1996)

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• Number of blood vessels as an indicator of response? - In another study of neuroblastoma, a group at the Robert Lurie Cancer Center in Chicago, counted the number of blood vessels supplying tumor per square mm (VI) on the slide and found that higher VI (>4) correlated with widely disseminated disease and poor survival (p=0.006 and p<0.0001), and was also associated with N-myc amplification, an indicator of aggressive disease and unfavorable histology. VI is an independent prognosticator, and it is possible that antiangiogenic therapy targeted against growth of new blood vessels may have value. (Meitar, J Clin Oncol 14:405, 1996)