Neuroblastoma is the most common extracranial solid tumor in children 0–14 years old. Current risk-adapted treatment programs are based on stratification of patient into three risk groups. 40–50% of patients are stratified into the high-risk group. The prognosis in high-risk patients remains poor (the probability of long-term survival is less than 50%), despite the use of aggressive multimodal therapy, including high-dose chemotherapy and autologous hematopoietic stem cell transplantation. In most cases tumor cells in neuroblastoma express disialoganglioside GD2, which is a possible target for immunotherapy. Over the past 30 years, GD2-directed chimeric monoclonal antibodies ch14.18 have been introduced into clinical practice. A number of clinical studies have shown an improvement in the prognosis in patients with high-risk neuroblastoma, when using monoclonal antibodies ch14.18, primarily due to the eradication of the minimal residual population of tumor cells resistant to standard chemotherapy. This literature review summarizes the international experience in the use of monoclonal antibodies ch14.18 from early phases of clinical trials to large randomized trials, which allowed immunotherapy to be considered as an important component of multimodal therapy for high-risk neuroblastoma. Future prospects for the use and place of immunotherapy in first-line therapy of high-risk neuroblastoma and in relapsed setting are considered.
Thymic carcinoma (TC) belongs to a group of rare thymic epithelial tumours (TETs) arising from the anterior mediastinum. One of the most relevant established prognostic factors is complete surgical resection. Given the high invasive potential of TC a lot of patents at the diagnosis present with a locally advanced or metastatic disease, therefore complete resection could not be achieved, and a role of systemic therapy is increasing. Due to the rarity of this tumor type in children and adolescents, treatment approaches based on the guidelines for management of TETs in adults. In this article we report a case of TC in a 2-year-old boy. The literature review describes the current histological classification of the TET, approaches for systemic chemotherapy and local control in patients with TC.
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