Diagnosis & Treatment

How is relapsed neuroblastoma diagnosed?

To make a diagnosis of relapsed neuroblastoma, your doctor may order a variety of tests, including:

In some cases, your doctor may also order a tumor biopsy, in which surgeons or interventional radiologists remove either a piece of the tumor or the whole tumor, depending on tumor location and size. Pediatric pathologists will analyze the tumor, and other important tests will be done to determine the tumor biology, such as genetic studies to look for genes that may be targeted using new drugs.

After all tests are completed, doctors will be able to outline the best treatment options.

What are the treatment options for relapsed and refractory neuroblastoma?

There is no standard treatment for relapsed neuroblastoma. Rather, our treatment approach is personalized for each patient depending on several factors, including:

  • extent of relapse
  • length of time from prior treatment
  • type of prior treatment

Treatment options for relapsed neuroblastoma include MIBG therapy, which uses a radioactive isotope that is readily absorbed by most neuroblastomas and can be used to detect neuroblastoma in the body or to deliver radiation in order to kill the neuroblastoma cells. It may also include chemotherapy using combinations of chemotherapy agents not used to treat newly diagnosed neuroblastoma, or immunotherapy generally given in combination with chemotherapy.

We also offer innovative clinical trials of experimental agents (Phase 1 or 2) for children with relapsed or recurrent neuroblastoma. Some of these were launched by our own physicians, while others are available through our participation in collaborative groups such as the New Approaches to Neuroblastoma Therapy (NANT) consortium, the Children's Oncology Group (COG) and the Pediatric Oncology Experimental Therapeutics Investigators' Consortium (POETIC).

What is the current research for relapsed neuroblastoma?

Research is a top priority at Dana-Farber/Boston Children's Cancer and Blood Disorders, and our physicians work continuously to translate laboratory findings into clinical therapies.

It’s possible that your child will be eligible to participate in one of the Neuroblastoma Program’s current clinical trials. In addition to launching our own clinical trials, we also offer the most Phase I studies in New England for children whose disease has recurred through the Children's Oncology Group and the New Approaches to Neuroblastoma Therapy (NANT) consortium.

Our current research efforts focus on improving established therapies for newly diagnosed and relapsed or recurrent neuroblastoma, studying the genetic causes of the disease and developing novel therapies. For instance, recent laboratory and animal studies by researchers at Dana-Farber/Boston Children's have focused on ways to counter MYCN amplification, one of the most common genetic features of aggressive neuroblastomas.

Our researchers are also teasing apart the relationship between neuroblastoma and a gene called ALK. We are working on therapies that target this gene and may improve treatment for newly diagnosed and relapsed neuroblastoma.