Immunotherapy for neuroblastoma

Immunotherapy is an important stage of treatment for children with high‑risk neuroblastoma. It uses the body’s own immune system to help keep the cancer in remission and reduce the chances of it returning. Immunotherapy for neuroblastoma is sometimes called antibody therapy.

Immunotherapy is usually given after high‑dose chemotherapy and stem‑cell transplant, as part of the consolidation phase of treatment.

How immunotherapy works.

Immunotherapy helps the immune system recognise and destroy neuroblastoma cells. It targets a molecule on the surface of neuroblastoma cells called GD2, which is not found on most healthy cells. GD2 plays a role in cancer cell growth and survival, making it a useful treatment target.

Anti‑GD2 therapy (Dinutuximab beta)

The standard immunotherapy used for high‑risk neuroblastoma in the UK is Dinutuximab beta, a type of man‑made antibody known as a monoclonal antibody. It works by attaching itself to GD2 on cancer cells, marking them so the immune system can recognise and destroy them.

Solving Kids’ Cancer UK, alongside other charities, helped advocate for the National Institute for Health and Care Excellence (NICE) to recommend this treatment for use on the NHS in England and Wales.

Read more about the NICE appeal on dinutuximab beta.

How immunotherapy is given

Anti‑GD2 immunotherapy is delivered into the bloodstream over six months. Treatment usually includes:

• Five cycles, each lasting 35 days
• A 10‑day continuous intravenous infusion of Dinutuximab beta
• A 25‑day rest period between cycles

Your child will receive immunotherapy in a specialist children’s cancer centre, where they will be monitored closely by the clinical team.

Side effects 

Anti‑GD2 immunotherapy can cause side effects, although children vary in how they respond. 

Read more about the side effects of immunotherapy for neuroblastoma. 

Your child’s healthcare team will talk through expected side effects and how these can be managed. 

Retinoic acid (isotretinoin) 

Alongside anti‑GD2 immunotherapy, children usually take a retinoid medicine called 1,3‑cis‑retinoic acid (isotretinoin). This treatment encourages neuroblastoma cells to mature into more normal cells, reducing the chance of the cancer returning. 

It is taken as: 

• A capsule 
• Twice daily for two weeks 
• Followed by a two-week break, repeated over six months (your team may adapt this based on your child’s needs) 

Animated video on maintenance therapy during treatment for high-risk neuroblastoma

This video was produced as part of the SIOPEN High-Risk Neuroblastoma 2 Trial.