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Award-winning research sponsored by CCF

The Children’s Cancer Foundation(CCF) sponsored project “Treatment Outcome of Metastatic Neuroblastoma with Anti-ganglioside 2 Monoclonal Antibody (3F8): The Hong Kong Experience” was given the Société Internationale d'Oncologie Pédiatrique (SIOP) award in the 2009 SIOP Annual Meeting at Sao Paulo, Brazil.  SIOP Annual Meeting is the biggest international meeting specifically for those who manage children with cancer.

 

In this project, the Hong Kong Paediatric Haematology & Oncology Study Group (HKPHOSP) led by Prof.  Godfrey Chan of the Department of Paediatrics & Adolescent Medicine of Li Ka Shing Faculty of Medicine, the Hong Kong University, found that the new combined treatment modality including the immunotherapy can improve the 4 years overall survival of children with metastatic neuroblastoma from 17.6% to 49.2%.  The median survival duration also improved from 1.8 years to 5.2 years.

 

Neuroblastoma, a tumour of the sympathetic nerve tissue, is the most common solid tumour in children after leukaemia, brain tumour and lymphoma.  It usually arises from the suprarenal gland found above the kidneys in the abdomen.  But it can also occur in the chest, the neck and the pelvic cavity.  50% of the cases are found in children under the age of 2.  This tumour grows rapidly and more than 65% of them already have spread beyond the site of origin when the child is first examined. 

 

Prof. Chan said the incidence of the disease among Hong Kong children is approximately 5.1 per a million children.  The chance of cure for neuroblastoma depends on the site, histological characteristics, age of onset and the degree of tumour spread at the time of diagnosis.  For localised and well differentiated tumour in a child, the survival rate can be up to 90%.  If the tumor is widespread, the chance of survival is at best 20-30% only.  In general, neuroblastoma in infant less than 1 year of age will have better prognosis or even spontaneously regress.  

 

To increase the cure rate for the poor prognostic group, HKPHOSP has been studying the new combined treatment modality including the immunotherapy.   This new combined treatment, also named as antibody therapy in theUnited States, brings a new hope to the poor prognostic group. 

 

The antibody therapy is named after the drug 3F8.  3F8 is an abbreviation of a specific monoclonal antibody. 

 

‘3F8 binds to ganglioside-2 (GD2), which is a specific protein found on the surface of neuroblastoma cells. When3F8 is injected into the bloodstream, it binds to GD2 present on all neuroblastoma cells.  3F8 is hence targeted at the neuroblastoma cell and the binding triggers the patient's own immune system to attack the neuroblastoma cells as foreign invaders.  As a result, the patient’s own immune system will eliminate those3F8 bound neuroblastoma cells.’  Prof. Chan explained how the monoclonal antibody3F8 works in eliminating neuroblastmoa cells.

 

Are there any side effects of the therapy?  Prof. Chan nodded his head and said, ‘Pain is the major side effect.’  Since some sensory cells also has GD2 protein on their cell surface, when 3F8 binds to the GD2 of the sensory neurons, pain sensation will be elicited and the message will be sent to the brain.  The pain usually starts in the middle or end of the daily3F8 treatment.  Medicines such as morphine can be administered to control the pain.  Thankfully, the pain is self limiting and transient only.  

 

CCF has been subsidising more than 1.5 million in purchasing the therapy drugs (3F8) for the ongoing study conducted by HKPHOSP since 1999.  To date, more than 60 children suffering from metastatic neuroblastoma have been benefited from the therapy and almost half of them were cured from their illnesses.