• Event-free / disease-free survival (EFS, DFS, iDFS, RFS): In early-stage cancer: how long patients stay free of recurrence, progression, or death.
• MYCN amplification: Extra copies of the MYCN oncogene, found in about 20% of neuroblastomas, mark the most aggressive disease and define high risk at any age.
• INRG staging and risk groups: INRG staging is the international system that sorts neuroblastoma into four risk groups, from the lowest (often observed, sometimes regressing on its own) to high risk (about half of patients), using age under 18 months, spread, MYCN amplification, 11q status, ploidy and histology.
• ADCC (antibody-dependent cellular cytotoxicity): In ADCC, an antibody flags a cell, and NK cells recognise the flag and kill it.
• RACE for Children Act: A US law that makes drug companies test new targeted cancer drugs in children whenever the drug's target matters in a childhood cancer, instead of letting them skip children because their cancers are rare.
• Autologous stem cell transplant (ASCT): High-dose chemotherapy (melphalan in myeloma, BEAM in lymphoma) that would permanently destroy the bone marrow, made survivable by giving the patient back their own previously collected stem cells, which engraft in 10-14 days.
• Cytokine release syndrome (CRS): A flood of inflammatory signals when immune cells are activated en masse, causing fever, low blood pressure, and sometimes organ failure.

Biomarker results to ask for: MYCN amplification, ALK mutation, Age, stage, ploidy, Segmental chromosome aberrations, INRG stage and image-defined risk factors, Age (<18 months), MYCN amplification (FISH), ALK mutation/amplification, 11q aberration, 1p deletion, ploidy, segmental chromosomal aberrations, INPC histology, Urinary catecholamines (VMA/HVA), 123I-MIBG Curie score / 18F-MFBG PET, Bone marrow minimal residual disease (PHOX2B, TH qPCR), GD2 expression (near-universal).

Scans and tests linked to this cancer: SPECT/CT, Ultrasound, MIBG imaging and 131I-MIBG therapy.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

• Very-low / low risk (L1, MS): Observation with serial imaging for asymptomatic L1/MS (many regress); surgery alone for resectable L1; short chemotherapy only for symptoms or progression. (INRG staging and risk groups, Ultrasound)
• Intermediate risk: 2-8 cycles of moderate chemotherapy (carboplatin, etoposide, cyclophosphamide, doxorubicin) guided by response and biology; surgery; isotretinoin in some protocols. (Doxorubicin, Cytotoxic chemotherapy, INRG staging and risk groups)
• High-risk: Induction chemo → surgery → tandem transplant → RT → anti-GD2 + isotretinoin; lorlatinib if ALK-mutant. (Lorlatinib, Monoclonal antibodies)
• High risk: induction: 5-6 cycles (COG: topotecan-cyclophosphamide × 2 then cisplatin-etoposide, cyclophosphamide-doxorubicin-vincristine; SIOPEN: rapid COJEC); stem-cell harvest; ANBL1531 adds 131I-MIBG (randomised) or lorlatinib (ALK); ANBL17P1 adds dinutuximab to induction. (COG ANBL1531, 131I-MIBG (iobenguane I-131) therapy, Lorlatinib, Dinutuximab (ch14.18) / dinutuximab beta, Doxorubicin)
• High risk: local control: Surgical resection of primary after induction (gross total where safe); external-beam radiotherapy 21.6 Gy to primary site (boost to residual) and MIBG-avid metastatic sites; proton therapy where available. (IMRT / IGRT (modern external beam), Proton therapy)
• High risk: consolidation: Tandem autologous transplant (thiotepa-cyclophosphamide, then CEM) in North America (ANBL0532); single busulfan-melphalan transplant in Europe (HR-NBL1). (Tandem autologous transplant, Autologous stem cell transplant (high-dose therapy), COG ANBL0532, SIOPEN HR-NBL1)
• High risk: post-consolidation: Anti-GD2 antibody (dinutuximab + GM-CSF + isotretinoin; dinutuximab beta in Europe, no IL-2) × 5-6 cycles; then eflornithine maintenance 2 years (US, 2023). (Dinutuximab (ch14.18) / dinutuximab beta, COG ANBL0032, Eflornithine (DFMO), NMTRC003/003B (DFMO maintenance), Caution: IL-2 added to anti-GD2 therapy)
• Relapsed / refractory: Irinotecan-temozolomide + dinutuximab or naxitamab (ANBL1221); naxitamab + GM-CSF for marrow/bone disease; 131I-MIBG for MIBG-avid disease; lorlatinib for ALK; GD2 CAR-T (Italy, trials); DFMO-based maintenance; palliative radiotherapy. (Dinutuximab (ch14.18) / dinutuximab beta, Naxitamab, Naxitamab Study 201, 131I-MIBG (iobenguane I-131) therapy, Lorlatinib, GD2-CART01 (Bambino Gesù phase 1/2), Anti-GD2 antibody + irinotecan-temozolomide (chemoimmunotherapy))
• Survivorship: Audiology (platinum, DFMO), endocrine and fertility follow-up, cardiac surveillance (anthracycline), second-malignancy screening, neurocognitive support; lifelong late-effects clinic. (Cardio-oncology)

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.