# MYCN amplification

Source: https://onco.cc/biomarkers/mycn-amp/  
OnCo record `mycn-amp` (Biomarker). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

MYCN amplification, more than four times the normal copy number of the gene on FISH, marks the most aggressive fifth of neuroblastomas and puts a child in the high-risk group whatever their age or stage. No drug targets it; it decides how much treatment is given.

## Summary

The INRG and COG definitions call MYCN amplified when the signal count is more than four times that of the chromosome 2 reference (or more than 10 copies), by FISH on tumour or bone marrow. Amplification is present in about 20 percent of neuroblastomas and assigns high risk in the INRG classification irrespective of other features (except some stage L1 tumours), triggering induction chemotherapy, surgery, tandem transplant, radiotherapy and anti-GD2 immunotherapy with dinutuximab. Dinutuximab's label describes high-risk neuroblastoma without naming MYCN. Amplification also defines a spinal ependymoma subtype and is found in some medulloblastomas.

## Fields

- Kind: Biomarker
- Last checked: 2026-09-23
- Also known as: MYCN amplification; MYCN-amplified; MYCN amp; N-myc amplification; MYCN-amplified neuroblastoma; MYCN FISH
- Tags: biomarker; paediatric; no-approval

## Sources

- INRG classification (Cohn et al. 2009): https://doi.org/10.1200/JCO.2008.16.6785
- Unituxin prescribing information (DailyMed): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d66bdf0d-9d65-45de-ae5b-a58617c27492

## Connected records

- biomarkers: [TP53 mutation and del(17p)](https://onco.cc/biomarkers/tp53-del17p/)
- cancers: [High-risk neuroblastoma](https://onco.cc/cancers/neuroblastoma-high-risk/), [Intermediate-risk neuroblastoma](https://onco.cc/cancers/neuroblastoma-intermediate-risk/), [Neuroblastoma (paediatric)](https://onco.cc/cancers/neuroblastoma/)
- drugs: [Dinutuximab (ch14.18) / dinutuximab beta](https://onco.cc/drugs/dinutuximab/)
- terms: [FISH / ISH (in situ hybridisation)](https://onco.cc/terms/fish/), [Gene amplification and copy-number change](https://onco.cc/terms/gene-amplification/), [MYCN amplification](https://onco.cc/terms/mycn-amplification/), [Segmental chromosomal aberrations and ploidy (neuroblastoma)](https://onco.cc/terms/segmental-chromosomal-aberrations/)
- targets: [MYCN (N-myc)](https://onco.cc/targets/mycn/)

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