What is the treatment for relapsed neuroblastoma? 

Relapsed neuroblastoma is when the cancer returns either during or after treatment, after initially responding well. Because every child’s situation is different, there is no single standard treatment pathway. Instead, doctors tailor treatment to your child’s needs using the best available evidence.  

Your child’s team will consider several factors including: 

• where the cancer has returned 
• how long it has been since your child’s earlier treatment 
• your child’s age and overall health 
• the biological and genetic features of the tumour (for example, ALK mutations or MYCN status) 

Because every child’s situation is different, your child’s specialist team will recommend an approach based on the best available evidence and your child’s individual circumstances. 

Treatment options  

Treatment for relapsed neuroblastoma may involve one or more of the following: 

Chemotherapy 
Different chemotherapy drugs or combinations may be used to try to shrink or control the cancer. The chemotherapy plan may be different from your child’s first treatment.  

Targeted therapies 
Some medicines target specific genetic changes in the tumour. For example, if the tumour has an ALK mutation, an ALK‑targeted treatment may be considered if available and appropriate.  

Immunotherapy 
Immunotherapy aims to help the immune system recognise and attack neuroblastoma cells. In some situations, immunotherapy may be used as part of treatment for relapsed disease which might be given in combination with other treatments.  

Radiotherapy or molecular radiotherapy 
Radiotherapy may be used to treat specific areas. Some children may also be offered molecular radiotherapy, such as mIBG therapy, which delivers radiation to neuroblastoma cells that take up mIBG. 

Clinical trials 
Clinical trials may offer access to newer treatments, or different ways of using existing treatments. Your child’s medical team can explain what trials may be suitable and what taking part would involve. 

Read more about clinical trials for relapsed neuroblastoma. 

Why treatment varies after relapse 

Relapsed neuroblastoma can behave differently from one child to another. This means: 

• treatment plans are highly individual 
• options may change depending on how the cancer responds 
• doctors may use a combination of approaches over time 
• your child’s plan may look different from other families’ experiences 

Your child’s medical team should be able to explain the reasons for each recommendation, what they are hoping to achieve, and the possible benefits and risks. 

Further information 

More detailed information about treatment approaches for relapsed and refractory neuroblastoma is available in the joint patient information booklet produced by the Children and Young People’s Cancer Association (CCLG), Solving Kids’ Cancer UK and Neuroblastoma UK.

CCLG Relapse and Refractory Neuroblastoma Guide