ideasIdea
GD2 CAR-T as consolidation in high-risk neuroblastoma
Give engineered GD2 T cells to children in remission after standard therapy, where the long-term data show the deepest and longest cures.
GD2-CART01 long-term follow-up: 5 of 8 patients infused with no evidence of disease remain disease-free at 10-15 years, versus ~50% relapse expected. Consolidation replaces or follows tandem transplant and anti-GD2 antibody.
Hypothesis
GD2 CAR-T consolidation after induction, surgery and transplant improves 3-year EFS from ~60% to ≥75% in high-risk neuroblastoma with acceptable CRS and no chronic neuropathy.
Rationale
Minimal residual disease is the ideal CAR-T setting; GD2 is retained after chemotherapy; safety switch mitigates risk.
What would test it
Randomised phase 2/3 within COG or SIOPEN: standard anti-GD2 immunotherapy vs anti-GD2 followed by GD2 CAR-T; EFS primary.
Maturity
early clinical