{"doi":"10.3390/cancers18061028","title":"End-of-Induction Response and Tolerability of High-Risk Neuroblastoma Treated with Chemoimmunotherapy—Modified N7 Regimen with Dinutuximab Beta","abstract":"<jats:p>Background: The integration of anti-disialoganglioside GD2 (anti-GD2) immunotherapy during induction chemotherapy has emerged as a promising strategy to improve outcomes in high-risk neuroblastoma (HR-NB). This study evaluated the end-of-induction (EOI) response and tolerability of a modified N7 induction regimen combined with dinutuximab beta in a Hong Kong paediatric cohort. Methods: A retrospective territory-wide analysis was conducted on nine HR-NB patients treated from 2022 to 2025. They received a modified N7 chemotherapy backbone with dinutuximab beta (17.5 mg/m2/day for 4 days per cycle), alongside granulocyte–macrophage colony-stimulating factor (GM-CSF) and low-dose interleukin-2. Response was assessed using the Revised International Neuroblastoma Response Criteria (INRC), and toxicity was graded according to the Common Terminology Criteria for adverse events (CTCAE). Results: The EOI objective response rate was 78% (7/9 patients) for the primary tumour site and 100% at metastatic sites. No patient exhibited progressive disease. A modified Curie score of ≤2 on MIBG scan was achieved in 78% of patients. Grade 3 or higher toxicities, including neutropenic fever, enterocolitis, and capillary leak syndrome, were observed in eight patients but were manageable. Conclusions: The incorporation of dinutuximab beta into a modified N7 induction regimen demonstrates a satisfactory EOI response rate and a manageable safety profile in children with HR-NB. These preliminary results support the feasibility of this chemoimmunotherapy approach and warrant further investigation in larger cohorts to confirm its efficacy in long-term survival outcomes.</jats:p>","journal":"Cancers","year":2026,"id":641759,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1668784,"name":"Calvin P. L. Hoo","orcid":null,"position":1,"is_corresponding":false},{"id":1668785,"name":"Ho Ming Cheung","orcid":null,"position":2,"is_corresponding":false},{"id":1668786,"name":"I. W. C. Wong","orcid":"0000-0002-0098-5570","position":3,"is_corresponding":false},{"id":1668788,"name":"K. F. Kevin Fung","orcid":null,"position":4,"is_corresponding":false},{"id":1668790,"name":"Sylvia L. Y. Chang","orcid":null,"position":5,"is_corresponding":false},{"id":1668791,"name":"Anselm C. W. Lee","orcid":null,"position":6,"is_corresponding":false},{"id":1668793,"name":"Eric C. H. Fu","orcid":null,"position":7,"is_corresponding":false},{"id":1668795,"name":"Dennis T. L. Ku","orcid":"0000-0003-0948-9132","position":8,"is_corresponding":false},{"id":1668797,"name":"Jeffrey P. W. Yau","orcid":"0009-0001-5943-2735","position":9,"is_corresponding":false},{"id":1668800,"name":"Matthew M. K. Shing","orcid":"0000-0002-6641-9854","position":10,"is_corresponding":false},{"id":1668802,"name":"Christy Y. K. Mak","orcid":"0000-0002-4261-7629","position":11,"is_corresponding":false},{"id":1251634,"name":"Anthony P. Y. Liu","orcid":null,"position":12,"is_corresponding":false},{"id":1668804,"name":"Godfrey C. F. Chan","orcid":null,"position":13,"is_corresponding":false},{"id":1668783,"name":"Evelyn R. Lu","orcid":"0009-0009-8079-1845","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"End-of-Induction Response and Tolerability of High-Risk Neuroblastoma Treated with Chemoimmunotherapy—Modified N7 Regimen with Dinutuximab Beta","abstract":"<jats:p>Background: The integration of anti-disialoganglioside GD2 (anti-GD2) immunotherapy during induction chemotherapy has emerged as a promising strategy to improve outcomes in high-risk neuroblastoma (HR-NB). This study evaluated the end-of-induction (EOI) response and tolerability of a modified N7 induction regimen combined with dinutuximab beta in a Hong Kong paediatric cohort. Methods: A retrospective territory-wide analysis was conducted on nine HR-NB patients treated from 2022 to 2025. They received a modified N7 chemotherapy backbone with dinutuximab beta (17.5 mg/m2/day for 4 days per cycle), alongside granulocyte–macrophage colony-stimulating factor (GM-CSF) and low-dose interleukin-2. Response was assessed using the Revised International Neuroblastoma Response Criteria (INRC), and toxicity was graded according to the Common Terminology Criteria for adverse events (CTCAE). Results: The EOI objective response rate was 78% (7/9 patients) for the primary tumour site and 100% at metastatic sites. No patient exhibited progressive disease. A modified Curie score of ≤2 on MIBG scan was achieved in 78% of patients. Grade 3 or higher toxicities, including neutropenic fever, enterocolitis, and capillary leak syndrome, were observed in eight patients but were manageable. Conclusions: The incorporation of dinutuximab beta into a modified N7 induction regimen demonstrates a satisfactory EOI response rate and a manageable safety profile in children with HR-NB. These preliminary results support the feasibility of this chemoimmunotherapy approach and warrant further investigation in larger cohorts to confirm its efficacy in long-term survival outcomes.</jats:p>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41899628","pmcid":"PMC13025792","openalex_id":"https://openalex.org/W7140082124","authors":[],"funders":[],"total_grants":0,"fwci":0.0,"citation_percentile":0.27702234,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.mdpi.com/2072-6694/18/6/1028/pdf","host_type":"journal"},{"url":"https://www.mdpi.com/2072-6694/18/6/1028/pdf","host_type":"publisher"},{"url":"https://doi.org/10.3390/cancers18061028","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/41899628","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13025792/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC13025792","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC13025792?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Neuroblastoma Research and Treatments","Cancer therapeutics and mechanisms","Cancer Research and Treatments"],"mesh_terms":[],"keywords":["Tolerability","Regimen","Neuroblastoma","Induction chemotherapy","Chemoimmunotherapy","Chemotherapy","Adverse effect","Immunotherapy","High-risk Neuroblastoma","Anti-gd2","Dinutuximab Beta","Modified N7"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-07T20:11:07.434814Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}