{"entity":{"id":"paper-anbl1221-irinotecan-temozolomide-dinutuximab-mody-lancet-oncol-2017","kind":"paper","name":"ANBL1221: irinotecan-temozolomide with temsirolimus or dinutuximab in relapsed or refractory neuroblastoma","aka":[],"tldr":"In children whose neuroblastoma had come back, adding the anti-GD2 antibody dinutuximab to irinotecan and temozolomide shrank the cancer in half of them, while adding temsirolimus almost never did.","summary":"Children's Oncology Group open-label randomised phase 2 selection trial: 35 eligible children with relapsed, refractory or progressive neuroblastoma were randomised to irinotecan and temozolomide with temsirolimus (n 18) or with dinutuximab plus GM-CSF (n 17).\n\nOne patient (6 percent) responded with temsirolimus against nine (53 percent, four partial and five complete responses) with dinutuximab. Pain, hypokalaemia, neutropenia, thrombocytopenia, anaemia, fever and hypoxia were the common grade 3 or worse events with dinutuximab; no deaths were attributed to treatment.","asOf":"2026-09-22","links":[{"label":"Lancet Oncol 2017","url":"https://doi.org/10.1016/S1470-2045(17)30355-8"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28549783/"}],"tags":[],"related":[],"cancers":["neuroblastoma-high-risk","neuroblastoma"],"sections":[],"technologies":[],"targets":[],"drugs":["dinutuximab","irinotecan","temozolomide","temsirolimus"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["anbl1221"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet-oncology"],"dependsOn":[],"notes":[],"journal":"The Lancet Oncology","year":2017,"doi":"10.1016/S1470-2045(17)30355-8","pmid":"28549783","authors":"Mody R, Naranjo A, Van Ryn C, et al.","paperType":"rct","findings":["Objective response 53 percent (95% CI 29.2 to 76.7) with irinotecan-temozolomide-dinutuximab versus 6 percent (0.0 to 16.1) with irinotecan-temozolomide-temsirolimus.","Grade 3 or worse pain in 44 percent and hypokalaemia in 38 percent of dinutuximab patients; one grade 4 hypoxia met unacceptable toxicity criteria."],"whatItMeans":"Chemo-immunotherapy with dinutuximab became the salvage standard for relapsed neuroblastoma and the regimen to move into first-line induction.","caveats":["Small randomised selection design intended to pick an arm for further study, not to prove superiority."],"changedPractice":true,"participants":35},"route":"/key-papers/paper-anbl1221-irinotecan-temozolomide-dinutuximab-mody-lancet-oncol-2017/","neighbours":{"cancer":[{"id":"neuroblastoma-high-risk","kind":"cancer","name":"High-risk neuroblastoma","route":"/cancers/neuroblastoma-high-risk/"},{"id":"neuroblastoma","kind":"cancer","name":"Neuroblastoma (paediatric)","route":"/cancers/neuroblastoma/"}],"drug":[{"id":"dinutuximab","kind":"drug","name":"Dinutuximab (ch14.18) / dinutuximab beta","route":"/drugs/dinutuximab/"},{"id":"irinotecan","kind":"drug","name":"Irinotecan (and liposomal irinotecan)","route":"/drugs/irinotecan/"},{"id":"temozolomide","kind":"drug","name":"Temozolomide","route":"/drugs/temozolomide/"},{"id":"temsirolimus","kind":"drug","name":"Temsirolimus","route":"/drugs/temsirolimus/"}],"trial":[{"id":"anbl1221","kind":"trial","name":"ANBL1221","route":"/trials/anbl1221/"}],"journal":[{"id":"lancet-oncology","kind":"journal","name":"The Lancet Oncology","route":"/journals/lancet-oncology/"}]}}