A step towards better precision in treatment
A revised Neuroblastoma Risk Classification System for North America is a step towards better precision in treatment and benefit all children with neuroblastoma.
A new international risk classification system has been developed for children with neuroblastoma in North America, with further revisions that could benefit children with the disease around the world.
In a study published in the Journal of Clinical Oncology this July, a group of collaborators from the Children’s Oncology Group (OCG), co-led by The Hospital for Sick Children (SickKids) and Children's Hospital of Philadelphia (CHOP) updated and validated a new classification system for North America. It now incorporates genetic information and surgical staging that have become available since the adoption of the previous version about 20 years ago.
An important part of a jigsaw
The very variable nature of neuroblastoma with some tumours spontaneously regressing, and even disappearing, in contrast to others which do not respond to the most aggressive therapy, demands a personalised approach.
This publication is an important part of a jigsaw of steps, which together will substantially improve the accuracy of classifying neuroblastoma tumours. This will result in treatment being precisely tailored to the needs of each child.
It is critical that every child with neuroblastoma receives the amount of treatment he or she needs - not too much, which would result in unnecessary acute and long term side effects; and not too little which would result in relapse. The very variable nature of neuroblastoma with some tumours spontaneously regressing, and even disappearing, in contrast to others which do not respond to the most aggressive therapy, demands a personalised approach. Moreover the current highly intensive treatment for high-risk neuroblastoma with two high-dose therapies heightens the need for precision.
The international neuroblastoma risk group (INRG) system published in 2009 was a very important landmark in this process. In parallel to this, a new staging system was developed, known as the International Neuroblastoma Risk Group Staging System (INRGSS).
The Revised Neuroblastoma Risk Classification System by the Children’s Oncology Group builds on this platform and includes the INRGSS and genetic abnormalities of the tumour (segmental chromosome aberrations [SCA]. This new classification improves the precision and is an advance for North America.
How will this help children with neuroblastoma outside of North America?
Globally, the next step is to revise the INRG and include more patients (approximately 14,000) and very importantly more genetic features of the tumours.
This revision has started and when complete will be a major advance and benefit all children with neuroblastoma.