Neuroblastoma Treatment

What is neuroblastoma?

As a fetus grows in the womb, it develops nerve cells called neuroblasts. Very rarely, these cells can become cancerous as the fetus grows or after the child is born, causing neuroblastoma. Neuroblastoma most commonly develops in the adrenal grands, near the kidneys, but it can also be found in the abdomen, spine, chest, or anywhere in the body.

Most children with neuroblastoma are diagnosed before age 5 and symptoms can range from a painless bump in the abdomen to fevers and limp.

How is neuroblastoma treated?

Many factors influence neuroblastoma treatment, including your child’s age, whether the tumor has already spread beyond its initial location and the risk of the tumor growing or spreading in the future.

When the tumor is isolated to one location, surgery can sometimes be used to remove it. In some cases, chemotherapy drugs are also given before surgery to help shrink the tumor or after surgery to kill any cancer left behind.

If your child is older than 18 months and the tumor has spread to another location, neuroblastoma is usually classified as high-risk. High-risk neuroblastoma treatment involves several different treatment methods working together to destroy the cancer and prevent it from spreading.

Patients with high-risk neuroblastoma are typically treated with chemotherapy, surgery, stem cell transplantation, radiation and immunotherapy.

Immunotherapy takes a child’s immune cells, or T cells, and helps them better recognize and attack cancer cells. For example, we are the only hospital in California to offer a clinical trial using chimeric antigen receptor (CAR) T cells that are designed to target a protein on cancer cells called GD2.

Newer combinations of chemotherapy and immunotherapy are also used in some cases. For example, we are one of a select group of hospitals to offer a clinical trial testing the combination of two immunotherapy drugs in patients whose neuroblastoma has come back or hasn’t responded to treatment. Both of these trials are based on research conducted at Stanford.

MIBG therapy is another emerging treatment option for high-risk neuroblastoma. 131I-MIBG is a special form of radiation that targets neuroblastoma cells directly. Unlike chemotherapy and traditional radiation, MIBG radiation kills neuroblastoma cells without causing as much damage to healthy cells.

Why choose Stanford Medicine Children’s Health for neuroblastoma treatment?

Successful neuroblastoma treatment starts with the right diagnosis. Stanford’s Hiroyuki Shimada, MD, is the director of the Children’s Oncology Group Neuroblastoma Pathology Reference Laboratory. This means he reviews pathology samples from roughly 700 neuroblastoma cases from around the world every year. He is also the founder of the International Neuroblastoma Pathology Classification, which helps ensure the right diagnosis so that patients get the best treatment for their cancer.

We offer all of the latest treatment options. Our team of neuroblastoma experts will create the best treatment plan for your child. Our doctors and researchers are also pushing neuroblastoma treatment forward nationally, developing new ways to attack neuroblastoma with antibodies and CAR T-cells:

  • Stanford doctor and researcher Crystal Mackall, MD, leads the Pediatric Cancer Immunotherapy Trials Network, a group of children’s hospitals creating new ways to use the body’s own immune system to attack neuroblastoma and other cancers.
  • The team led research using two immunotherapy drugs to attack neuroblastoma that paved the way for a clinical trial now available at Stanford and select other hospitals across the nation.
  • Dr. Mackall led research that identified a new target on the surface of neuroblastoma cells, GD2. We are now the only hospital in California to offer a clinical trial that helps a patient’s immune system better identify the GD2 target and attack cancer cells (immunotherapy).

When it comes to another promising treatment, MIBG therapy, we are one of only two hospitals in California to be able to offer this innovative approach. At our hospital, patients receiving MIBG therapy stay in a dedicated room, and their parents or caregivers stay in a connected room, separated only by glass. Families appreciate being able to stay close and continue to interact during treatment.

We are accredited by the Foundation for the Accreditation of Cellular Therapy (FACT) for stem cell transplantation and immunotherapy.