Maintenance therapies after completing treatment for neuroblastoma 

Maintenance therapies are treatments designed to be given once a child is in remission, with the aim being to help reduce the risk of the cancer coming back.

You may see these approaches described using different terms, including maintenance therapy, continuation therapy, or relapse‑prevention therapy. These terms are used in different ways by different teams, and there is no single agreed definition.

Treatment for high‑risk neuroblastoma usually involves several stages, which may include chemotherapy, surgery, high‑dose chemotherapy with stem cell rescue, radiotherapy  immunotherapy.

Additional therapy following the completion of NHS treatment is not considered standard of care in the UK and so choosing to access additional therapies is an individual family choice that should be made in partnership with the child's clinical team. It is important to note that additional therapies that are outside of NHS treatment can come at a significant cost and often involve travel abroad.

Where do maintenance therapies fit in the treatment pathway?

Maintenance therapies are sometimes considered once a child is in remission, either at the end of frontline treatment, or after being treated for relapse. Their purpose is to help maintain remission rather than to treat active disease.

It’s important to know that:

• Whether an additional therapy is appropriate will depend on a child’s individual situation and should be discussed with the child's clinical team. 
• Access to additional maintenance therapies at the end of NHS frontline treatment is therefore through individual patient programmes or clinical trials. 
• Evidence for these approaches is still developing. 
• Treatments outside of NHS standard of care can often come at a significant cost and usually involve travelling abroad.  

How do different types of maintenance therapies work? 

Maintenance or relapse‑prevention approaches aim to keep neuroblastoma in remission in different ways, depending on the treatment. Some of the approaches families hear about may include: 

• Immune‑based approaches, which aim to help the immune system recognise and respond to neuroblastoma cells. 

• Metabolic or differentiation‑based approaches, which affect how cells grow, divide or mature. 

• Cell‑based therapies, which are tailored to each individual patient. 

These approaches are an active area of research, and there is uncertainty about how much benefit any individual child may gain. 

What maintenance therapy options might be available for my child? 

Some of the different maintenance therapies that might be available for your child include: 

DFMO (also known as eflornithine or Iwilfin): an oral medication sometimes described as continuation therapy. 

Read more about DFMO and how it is accessed.

GD2/GD3 bivalent vaccine: a form of active immunotherapy delivered via a series of vaccinations. 

Read more about the bivalent vaccine and how it is accessed.

Your child’s consultant is the best person to advise whether it is appropriate to explore any of these options further. 

Questions about maintenance therapies?

Reaching the end of treatment can feel like both a relief and a new source of uncertainty. If you have questions about whether maintenance therapies are relevant for your child, or about accessing treatment after standard NHS care, please discuss this with your child's clinical team in the first instance.

Video presentation on post-maintenance therapies

This presentation was recorded during our 2025 Neuroblastoma Parent Symposium.

Page last updated: July 28, 2026