Desai, Ami V.Applebaum, Mark A.Karrison, Theodore G.Oppong, AkosuaYuan, CindyBerg, Katherine R.MacQuarrie, KyleSokol, ElizabethHall, Anurekha G.Pinto, NavinWolfe, IanMody, RajenShusterman, SuzanneSmith, ValeriaFoster, Jennifer H.Nassin, MicheleLaBelle, James L.Bagatell, RochelleCohn, Susan L.2024-06-102024-06-102022Desai, A. V., Applebaum, M. A., Karrison, T. G., Oppong, A., Yuan, C., Berg, K. R., MacQuarrie, K., Sokol, E., Hall, A. G., Pinto, N., Wolfe, I., Mody, R., Shusterman, S., Smith, V., Foster, J. H., Nassin, M., LaBelle, J. L., Bagatell, R., & Cohn, S. L. (2022). Efficacy of post-induction therapy for high-risk neuroblastoma patients with end-induction residual disease. Cancer, 128(15), 2967–2977. https://doi.org/10.1002/cncr.34263https://hdl.handle.net/1805/41330Background: High-risk neuroblastoma patients with end-induction residual disease commonly receive post-induction therapy in an effort to increase survival by improving response prior to autologous stem cell transplant (ASCT). We conducted a multi-center, retrospective study to investigate the efficacy of this approach. Methods: Patients diagnosed between 2008 and 2018 without progressive disease (PD) with ≤ partial response (PR) at end-induction were stratified according to post-induction treatment: i) no additional therapy prior to ASCT (Cohort 1); ii) post-induction “bridge” therapy prior to ASCT (Cohort 2); and iii) post-induction therapy without ASCT (Cohort 3). Chi-square tests were used to compare patient characteristics. Three-year event-free survival (EFS) and overall survival (OS) were estimated by the Kaplan-Meier method and survival curves were compared by log-rank test. Results: The study cohort consisted of 201 patients; Cohort 1 (n=123); Cohort 2 (n=51); and Cohort 3 (n=27). Although end-induction response was better for Cohort 1 than Cohorts 2 and 3, outcome for Cohort 1 and 2 was not significantly different (EFS; p=0.77 and OS; p=0.85). Inferior outcome was observed for Cohort 3 (EFS; p<0.001 and OS; p=0.06). Among patients with end-induction stable metastatic disease, 3-year EFS was significantly improved for Cohort 2 compared to Cohort 1 (p=0.04). Cohort 3 patients with complete response (CR) in metastatic sites following post-induction therapy had significantly better 3-year EFS compared to those with residual metastatic disease (p=0.01). Conclusions: Prospective studies to confirm the benefits of bridge treatment and the prognostic significance of metastatic response observed in this study are warranted.en-USPublisher Policyneuroblastomatreatment responseprognosissurvivalautologous transplantationArticle