Arnold I Freeman, Ph.D., Roswell Park Memorial Institute, Buffalo, NY
Robert Bolande, MD, East Carolina School of Medicine, Greenville, NC
Garrett Brodeur, MD, St. Louis Children’s Hospital, St. Louis, MO
Arnold I. Freeman, MD, Roswell Park Memorial Institute, Buffalo, NY
Lawrence Helson, MD, Memorial Sloan-Kettering Hospital, New York, NY
Mark A. Israel, MD, National Cancer Institute, Bethesda, MD
John T. Kemshead, MD, Institute of Child Health, London, England
Rajko Medecina, MD, Ph.D., SCCOHI, Hilton Head Island, SC
Thierry Phillip, MD, Centre Leon Berard, Lyon, France
Patrick Reynolds, MD, Ph.D., Naval Medical Research Institute, Bethesda, MD
Cameron Tebbi, MD, Roswell Park Memorial Institute, Buffalo, MY
Patrick Thomas, MD, Mallinckrodt Institute of Radiology, St. Louis, MO
J. Uchino, MD, Hokkaido University, Sapporo, Japan
Layout and Goals
- Stages III and IV Neuroblastoma – Therapy
- Innovative Approaches to Therapy
- Neuroblastoma in Infancy & Control Factors
This meeting consisted of a small group of twelve scientific participants. The think tank was divided into three sessions. The first session was chaired by Dr. Lawrence Helson and dealt with current therapy in a far advanced neuroblastoma. The second session was chaired by Dr. John Kemshead and discussed innovative approaches to therapy including new treatments and possible future directions. The third session was chaired by Dr. Garrett Brodeur and discussed control factors in neuroblastoma.
Each session began with a brief case presentation of a patient who had suffered from neuroblastoma. An attempt to translate basic research to actual patient care was made. There were participants from around the world including Japan, Europe and England as well as the United States.
The enthusiasm generated by this meeting was very high among the scientific participants. It was considered that the think tank concept was excellent and of great value. Among the practical spinoffs that resulted from this meeting were:
- The need for standard terminology. The scientific participants will write a position paper to endorse this and will attempt to organize a subsequent meeting with participants from the United States, Europe and Japan so all can agree on common definitions.
- The need to establish a centralized, computerized tissue bank for patients with neuroblastoma and neural crest tumors.
- The testing of a panel of monoclonal antibodies currently available in Europe and in the United States to determine which are useful in diagnosis and classification. Drs. John Kemshead, Patrick Reynolds and Garrett Brodeur will develop this project.
- Dr. Patrick Reynolds has a technique which can determine tumor cells present in a ratio as minute as one cell per million, and has invited investigators at the think tank to share in his procedures and techniques.
- The possible use of hyperthermia (heating) with chemotherapy to augment the chemotherapeutic effect.
- The avoidance of radiation where possible, particularly in early stage disease, in order to avoid second primary cancers approximately ten years later.
- The possibility of a screening program (of urine in infants) to detect metabolites from neuroblastoma in the United States was considered after presentation of the screening program in Japan.
- Trials using retinoids (an agent which causes maturation of tumor cells rather than killing the tumor cells) in IV-S neuroblastoma (a tumor seen mostly in infants which tends to spontaneously mature and is often self-curing) rather than chemotherapy or radiation therapy in infants.