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Busulfan and melphalan as the high-dose conditioning before stem cell rescue gave better event-free survival and less severe toxicity than the carboplatin-etoposide-melphalan regimen in high-risk neuroblastoma, becoming Europe's standard.
Phase 3 trial within the European HR-NBL1 study randomising 598 children with high-risk neuroblastoma after rapid COJEC induction to busulfan-melphalan or carboplatin-etoposide-melphalan (CEM) high-dose chemotherapy with autologous stem cell rescue.
Three-year event-free survival was 50 versus 38 percent (hazard ratio about 0.7), overall survival 60 versus 48 percent, and severe toxicity and toxic deaths were fewer with busulfan-melphalan.
Busulfan-melphalan is the standard single high-dose regimen for high-risk neuroblastoma in Europe and many other regions; North America uses tandem transplant.
Shares SIOPEN HR-NBL1, High-risk neuroblastoma.
Shares Busulfan, High-risk neuroblastoma, Etoposide, Carboplatin.
Shares Etoposide, Carboplatin.
Shares Etoposide, Carboplatin.
Shares Etoposide, Carboplatin.
Shares Etoposide, Carboplatin.
Shares Etoposide, Carboplatin.