# Anti-GD2 antibody + irinotecan-temozolomide (chemoimmunotherapy)

Source: https://onco.cc/pairings/anti-gd2-plus-chemo-relapse/  
OnCo record `anti-gd2-plus-chemo-relapse` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding the anti-GD2 antibody to relapse chemotherapy doubled response rates in relapsed neuroblastoma, and the idea is now moving into first-line induction.

## Summary

Adding the anti-GD2 antibody dinutuximab to irinotecan and temozolomide chemotherapy is a combination pairing for relapsed neuroblastoma that has become the standard treatment at first relapse. Chemotherapy releases antigen and depletes suppressive cells while the antibody directs antibody-dependent cellular cytotoxicity against GD2, a disialoganglioside that chemotherapy does not downregulate. In the randomised phase 2 ANBL1221 trial the irinotecan-temozolomide-dinutuximab arm produced far more responses than the temsirolimus comparator, and a confirmatory expansion supported the result. The concept is now moving into first-line induction in ANBL17P1, which tests dinutuximab during induction, and naxitamab combined with chemotherapy shows a similar pattern.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Dinutuximab (ch14.18) / dinutuximab beta + Temozolomide
- Type: combination
- Rationale: Chemotherapy releases antigen and depletes suppressive cells while the antibody directs ADCC; GD2 is not downregulated by chemotherapy.
- Evidence: Randomised phase 2 (ANBL1221) and confirmatory expansion.

## Sources

- ANBL1221: irinotecan-temozolomide with temsirolimus or dinutuximab in children with refractory or relapsed neuroblastoma (Lancet Oncology 2017): https://doi.org/10.1016/S1470-2045(17)30355-8

## Connected records

- cancers: [High-risk neuroblastoma](https://onco.cc/cancers/neuroblastoma-high-risk/), [Neuroblastoma (paediatric)](https://onco.cc/cancers/neuroblastoma/)
- targets: [GD2 (disialoganglioside)](https://onco.cc/targets/gd2/)
- drugs: [Dinutuximab (ch14.18) / dinutuximab beta](https://onco.cc/drugs/dinutuximab/), [Naxitamab](https://onco.cc/drugs/naxitamab/), [Temozolomide](https://onco.cc/drugs/temozolomide/)

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