Introduction
Neuroblastoma is a rare form of cancer that develops in nerve cells, mostly affecting children under the age of five. It is one of the most common solid tumors in children, accounting for about 7% of all childhood cancers. However, it is also one of the most difficult to treat, as it often does not respond well to conventional therapies or relapses after initial treatment. The prognosis for children with neuroblastoma is poor, with less than half of them surviving for more than five years.
How does Bevacizumab work?
Bevacizumab is a type of targeted therapy called an angiogenesis inhibitor. It works by blocking a protein called VEGF, which some cancer cells produce in large amounts. Blocking VEGF may prevent the growth of new blood vessels that tumors need to grow and spread. By starving the tumors of oxygen and nutrients, Bevacizumab may slow down or stop their growth.
BEACON Trial
A new clinical trial, called BEACON, has offered a new hope for children with neuroblastoma who have failed or relapsed after standard treatment. The trial, conducted by the Cancer Research UK Clinical Trials Unit at the University of Birmingham and involving 43 hospitals in 11 European countries, tested the effectiveness of adding Bevacizumab to various chemotherapy drugs. The trial involved 160 young people aged 1–21, who were randomly assigned to receive either Bevacizumab plus chemotherapy or chemotherapy alone. The results, published in the Journal of Clinical Oncology, showed that the combination therapy led to more young people seeing their tumors shrinking, from 18% in the control group to 26% in the Bevacizumab group. The combination therapy also improved the one-year progression-free survival rates, from 20% to 29%.
Implications and Future Directions
The BEACON trial is one of the first to show that combining ICIs with chemotherapy can improve the outcomes for children with neuroblastoma who have limited treatment options. The trial also identified some promising drug combinations that can be further investigated in future studies. The data from the trial has been incorporated into the current UK Clinical Practice Guidelines and Bevacizumab is now recommended as a standard treatment for relapsed neuroblastoma.
The researchers hope that their findings will pave the way for more effective and personalized treatments for children with neuroblastoma and other cancers. They also plan to explore the molecular mechanisms behind the response and resistance to ICIs and chemotherapy, as well as the potential biomarkers that can predict which patients will benefit from the combination therapy.