# Caution: IL-2 added to anti-GD2 therapy

Source: https://onco.cc/pairings/il2-anti-gd2-caution/  
OnCo record `il2-anti-gd2-caution` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Interleukin-2 was part of the original immunotherapy package but a large European trial showed it adds toxicity and no benefit, so it has been dropped.

## Summary

Interleukin-2 was part of the original anti-GD2 immunotherapy package for high-risk neuroblastoma, and this caution pairing records why it has been dropped. In the R2 randomised comparison of the SIOPEN HR-NBL1 trial, adding subcutaneous IL-2 to dinutuximab beta produced no meaningful improvement in event-free survival but far more severe toxicity. The rationale is that IL-2 expands regulatory T cells and causes capillary leak, whereas the NK-cell-mediated antibody-dependent cytotoxicity that the anti-GD2 antibody relies on is sufficiently supported by GM-CSF. European protocols omit IL-2 and the Children's Oncology Group has since removed it as well in ANBL1531, so the combination now stands as a warning example within the broader cytokine therapy record.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Dinutuximab (ch14.18) / dinutuximab beta + Cytokines & engineered cytokines
- Type: caution
- Rationale: IL-2 expands regulatory T cells and causes capillary leak; NK-mediated ADCC is sufficiently supported by GM-CSF.
- Evidence: Randomised phase 3 (HR-NBL1).

## Sources

- ClinicalTrials.gov NCT01704716: SIOPEN HR-NBL1: https://clinicaltrials.gov/study/NCT01704716

## Connected records

- cancers: [High-risk neuroblastoma](https://onco.cc/cancers/neuroblastoma-high-risk/), [Neuroblastoma (paediatric)](https://onco.cc/cancers/neuroblastoma/)
- drugs: [Dinutuximab (ch14.18) / dinutuximab beta](https://onco.cc/drugs/dinutuximab/)
- trials: [SIOPEN HR-NBL1](https://onco.cc/trials/hr-nbl1/)
- technologies: [Cytokines & engineered cytokines](https://onco.cc/technologies/cytokine-therapy/)

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