# A3961: outcome after reduced chemotherapy for intermediate-risk neuroblastoma

Source: https://onco.cc/key-papers/paper-a3961-intermediate-risk-neuroblastoma-baker-nejm-2010/  
OnCo record `paper-a3961-intermediate-risk-neuroblastoma-baker-nejm-2010` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Cutting chemotherapy to four or eight cycles based on tumour biology kept three-year survival above 96 percent in intermediate-risk neuroblastoma, showing these children could be safely treated with substantially less.

## Summary

Children's Oncology Group prospective study of 479 children with intermediate-risk neuroblastoma treated with four cycles (favourable biology) or eight cycles (unfavourable biology) of carboplatin, etoposide, cyclophosphamide and doxorubicin, with surgery and no radiotherapy for most.

Three-year event-free survival was 88 percent and overall survival 96 percent, similar to historical results with more intensive therapy, with excellent outcomes in the favourable biology group (96 percent overall survival).

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: New England Journal of Medicine
- Year: 2010
- DOI: 10.1056/NEJMoa1001527
- Authors: Baker DL, Schmidt ML, Cohn SL, et al.
- Findings: Three-year overall survival 96 percent; event-free survival 88 percent.; Four cycles sufficient for favourable biology.
- What it means: Biology-based reduction of chemotherapy is the standard for intermediate-risk neuroblastoma, and the successor trial ANBL0531 reduced it further.
- Caveats: Non-randomised comparison with historical controls.

## Sources

- N Engl J Med 2010: https://doi.org/10.1056/NEJMoa1001527
- PubMed: https://pubmed.ncbi.nlm.nih.gov/20879880/

## Connected records

- cancers: [Intermediate-risk neuroblastoma](https://onco.cc/cancers/neuroblastoma-intermediate-risk/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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