ganglioside--gd2 and Ganglioneuroblastoma

Gangliosicle GD2 is abundant on human neuroblastoma (NB). Monoclonal antibody 3F8 targeted to GD2 may have imaging and therapeutic potential. Antigen-negative clones can escape immune-mediated attack leading to clinical resistance or recurrence.. Among 95 evaluable patients treated intravenously with 3F8 (94 Stage 4, 1 Stage 3), 66 received nonradiolabeled 3F8, 11 received 131-iodine-labeled-3F8 (8-28 mCi/kg) with autologous bone marrow rescue, and 18 received both forms of treatment. Prior to treatment, 90 patients tested positive for GD2 reactivity by bone marrow immunofluorescence (n = 68), tumor immunohistochemistry (n = 20), or diagnostic radioimmunoscintigraphy (n = 2).. Of 62 patients who had refractory or recurrent neuroblastoma following 3F8 treatment, 61 (98%) tested positive for GD2 reactivity by bone marrow immunofluorescence (n = 51) or tumor immunohistochemistry (n = 10). The sole tumor that lost GD2 expression underwent phenotypic transformation into a pheochromocytoma-like tumor.. The persistence of GD2 expression in refractory or recurrent NB suggests that complete antigen loss is an uncommon event and cannot account for treatment failure.

Topics: Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Antibody Specificity; Antigens, Neoplasm; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Bone Marrow Transplantation; Cell Lineage; Child, Preschool; Combined Modality Therapy; Fatal Outcome; Female; Ganglioneuroblastoma; Gangliosides; Humans; Immunization, Passive; Immunoconjugates; Immunoglobulin G; Iodine Radioisotopes; Male; Neoplasm Metastasis; Neuroblastoma; Radioimmunodetection; Radioimmunotherapy; Remission Induction; Retrospective Studies; Transplantation, Autologous