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Cutting chemotherapy to four or eight cycles based on tumour biology kept three-year survival above 96 percent in intermediate-risk neuroblastoma, showing these children could be safely treated with substantially less.
Children's Oncology Group prospective study of 479 children with intermediate-risk neuroblastoma treated with four cycles (favourable biology) or eight cycles (unfavourable biology) of carboplatin, etoposide, cyclophosphamide and doxorubicin, with surgery and no radiotherapy for most.
Three-year event-free survival was 88 percent and overall survival 96 percent, similar to historical results with more intensive therapy, with excellent outcomes in the favourable biology group (96 percent overall survival).
Biology-based reduction of chemotherapy is the standard for intermediate-risk neuroblastoma, and the successor trial ANBL0531 reduced it further.