Talk:Neuroblastoma

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Good article Neuroblastoma has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do. If it no longer meets these criteria, you can delist it, or ask for a reassessment.
January 2, 2008 Good article nominee Listed

doi:10.1016/S0140-6736(07)60983-0  - recent Lancet review JFW | T@lk 12:22, 24 June 2007 (UTC)

Contents

[edit] 3F8

I'm wondering what people think about creating a new page for discussion of the 3F8 antibody. Space could also be dedicated to discussion of Dr. Cheung's hu3F8. I suppose that a section could be added to this page, instead. Thoughts? MeredithParmer (talk) 07:12, 19 February 2008 (UTC)

I think it is a great idea! By the way, I did mention the humanized 3F8 effort, and spent a fair amount of time looking for a good reference. Since I could not find any, I took it back out. Can you supply a reference? Thanks for the excellent work! DMLudwinski (talk) 15:52, 19 February 2008 (UTC) I just looked at the Monoclonal antibody therapy article and perhaps you may be able to add a section to it for 3F8? A thought. DMLudwinski (talk) 17:39, 19 February 2008 (UTC)
I've created a stub for 3F8. --Arcadian (talk) 00:16, 20 February 2008 (UTC)

[edit] Etiology (Aetiology)

Changed "prevention" section to "etiology" and provided some up to date links to peer reviewed journals. Previous link was to a tabloid article that reported a beneficial effect of taking multivitamins, when the study was funded by a (you guessed it!) multivitamin company. Nor did it appear in peer reviewed journal. Apologies for number of separate page edits, but this was my first go. Ironick 10:37, 5 September 2007 (UTC)


[edit] Diagnosis

"The diagnosis is usually confirmed by a surgical pathologist, taking into account the clinical presentation, microscopic findings, and other laboratory tests. On microscopy, the tumor cells are typically described as small, round and blue, and rosette patterns (Homer-Wright pseudo-rosettes) may be seen. A variety of immunohistochemical stains are used by pathologists to distinguish neuroblastomas from histological mimics, such as rhabdomyosarcoma, Ewing's sarcoma, lymphoma and Wilms' tumor. The N-myc amplification is characteristic, and sometimes electron microscopy is also required." This contribution of mine was removed without discussion. I am a pathologist but have written it with the intelligent layman in mind. The present reference to neuron-specific enolase is wrong, and the whole paragraph was deleted without discussion. I would find it helpful if people explained their need to remove great slabs of info. Would fellow users care to comment? Hovea 22:55, 10 September 2007 (UTC)

Agreed, no idea why that should be excluded. I like the pathological description. I think this section needs work, perhaps even splitting "symptoms" from the diagnosis section, where less technical language can be used. Then this pathological info can be put back into the diagnosis/identification section. I really don't like the "great masquerader" line (unless it can be cited). Let me know your thoughts. Also the article needs some prevalence and survival data, as an Epidemiologist I will have a look and update this, I think Little 1999 (ISBN 92-832-2149-4) is likely to be the best source. Ironick 10:47, 11 September 2007 (UTC)


Thanks Ironick. I'm with you on this one & I've made a start. Hovea 23:07, 11 September 2007 (UTC)

I just noticed the above quoted material in in the article twice. Where do you think it fits best? DMLudwinski (talk) 16:12, 15 December 2007 (UTC)

I have removed the second instance of the duplicated text. --Arcadian (talk) 19:06, 15 December 2007 (UTC)

[edit] Changes to risk assignment and staging

I think this section should be changed to reflect the new INRG plan (ref Lancet June 2007 Maris et al). The stages will be called L1, L2, M and MS, and 12-18 month olds without N-myc amplification will be no longer considered high-risk (moved to intermediate risk).

This change in classification with 12-18 month olds (N-myc non-amp) started in the COG May 2004.

This material was also presented at the 2007 ASCO meeting, and virtual presentations are viewable online at ASCO Pediatric Cancers (Neuroblastoma Pediatric Cancer I and Neuroblastoma---Recent Advances in Biology and Therapy Education session) see Dr S Cohn abstract 9503

Thanks for the excellent work on this page! I would personally like to see a LOT more on pathology! DMLudwinski (talk) 23:12, 11 December 2007 (UTC)

(talk) 18:53, 11 December 2007 (UTC)

I have added a brief reference to this, but since you are familiar with the subject, I encourage you to expand it. (If possible, it would be more sustainable to cite the journal articles, rather than citing the videos.) --Arcadian (talk) 16:29, 13 December 2007 (UTC)

[edit] Pathology image

Arcadian, the image is great (as are other improvements to the article)! I noticed the image added is ganglioneuroblastoma, and checking the NCI link, there is a image of neuroblastoma also, showing the distinctive rosettes. Would that be a better image to include? Or both--since ganglioneuroblastoma is treated similarly to neuroblastoma (depending on the age and stage and risk assignment)? Thanks! I do not know how to add images (I am very slowly getting up to speed for editing, but plan to help here!)

DMLudwinski (talk) 15:48, 16 December 2007 (UTC)

First of all, let me commend you for your edits. You're learning quickly. Per the images: I'm not sure which image you're proposing to upload -- can you provide a URL? The image I added was from the German wiki page, so it was already in Wikimedia, and didn't need to be uploaded, just copied over to the English version. In most cases, works of the US government are public domain, but there are some exceptions (see Copyright status of work by the U.S. government, and Wikipedia:Uploading images). You may also want to ask at Wikipedia:Media copyright questions -- the users there specialize in these issues. --Arcadian (talk) 04:29, 19 December 2007 (UTC)

Thanks! I clicked on the image you added, and below the image the description states the source. I went to the cancer.gov source and did a search on neuroblastoma and found a photo of NB: neuroblastoma I think it public domain, but do not know how to add it to the NB article. Thanks for your help! DMLudwinski (talk) 19:35, 19 December 2007 (UTC)

I got it--I uploaded the neuroblastoma rosettes image from NCI and replaced the image of ganglioneuroblastoma which is wrongly labeled as "neuroblastoma.jpg" on the German wiki page. DMLudwinski (talk) 20:19, 20 December 2007 (UTC)
Nicely done. --Arcadian (talk) 22:30, 20 December 2007 (UTC)

[edit] GA review

I'll probably read through in detail tomorrow, but a first speed read suggests careful copyediting and checking for readability would be helpful. Just a quick read suggests MoS issues - eg ref numbers should follow punctuation with no space, and there are some places where glosses would help. The very last sentence, which looks odd, starting with a lower-case letter, would be much improved as "The protein p53...". There are places where a gloss for meaning might be helpful, esp if the phrase is a red-link. Jimfbleak (talk) 09:11, 30 December 2007 (UTC)

  1. ref numbers should follow punctuation with no space -I fixed several, not all. Ref 10 would be better at end of sentence
  2. Diagnosis- no refs for key first three paras
  3. Careful copyediting and checking for readability would be helpful. "Doesn't" is too informal, so is "this is how it works" "1980's" is wrong, should be "1980s". There may be others
  4. spell out y.o. for clarity
  5. gloss for multimodal therapy needed since the link is red and the meaning is not obvious
  6. The very last sentence, which looks odd, starting with a lower-case letter, would be much improved as "The protein p53...".

I'll do the formal review by Friday, please let me know if more time needed. Jimfbleak (talk) 08:11, 1 January 2008 (UTC)

  • Thanks Jimfbleak for the great observations for the much needed editing improvements, and all the corrections made. Your attention is so appreciated! I have not tackled any copy-related improvements because there are so many significant high-risk treatment-related issues that could be added and referenced (although as a newbie I find doing references confusing!)
    • including the new COG phase III trial that opened 12/2007 to randomize single vs tandem transplant (will accrue 495),
    • and the studies leading up to this trial,
    • recently released preliminary results of phase III study (to purge or not to purge stem cells, closed spring 2006)
    • and the still-open phase III trial randomizing anti-GD2 antibody ch14.18 with cytokines with 13-cis-retinoic acid vs just 13cisRA,
    • the single-institution anti-GD2 antibody 3F8 used for the past 20 years at Memorial Sloan Kettering in New York
    • I would like to see the recent European trials included, especially the open German NB2004 and the open SIOPEN trial using a rapid COJEC chemotherapy regimen.

Much work to be done here! Thanks so much.208.123.11.69 (talk) 18:15, 1 January 2008 (UTC)

The items listed by Jimfbleak for the good article review have now (I believe) been addressed. --Arcadian (talk) 18:48, 1 January 2008 (UTC)
Per the items listed by 208.123.11.69 -- if you can bring PMIDs or URLs to this talk page, I would be happy to help in the reference formatting. --Arcadian (talk) 18:52, 1 January 2008 (UTC)
THANKS, will do! Having trouble with my login as well, now fixed I think. DMLudwinski (talk) 19:31, 1 January 2008 (UTC)

[edit] Current clinical trials (frontline therapy) for high-risk neuroblastoma

Thanks for the offer of help with references Arcadian. Below is an accumulation of information on clinical trials with external links. It may be too much and I have no problem with it being greatly simplified or ignored altogether. There is a little more to be said about efforts with anti-GD2 antibodies which I can add later. DMLudwinski (talk) 16:33, 2 January 2008 (UTC)

Currently there is no “standard” frontline treatment for high-risk neuroblastoma because the relapse rate is still unacceptably high. In an effort to improve survival rates for high-risk neuroblastoma, various therapies (clinical trials) are planned and carried out by cooperative groups as well as individual and small groups of institutions. Many patients are needed for phase III (randomized) trials to discern the effectiveness of new therapies. Worldwide incidence of high-risk NB is estimated to be 6,000 to 7,000 annually--compared to only 300-350 in the US-- so cooperative groups are often international.

A short history of phase III studies for high-risk neuroblastoma

Children's Oncology Group (COG) http://www.curesearch.org/resources/cog.aspx is the result of a merger http://jnci.oxfordjournals.org/cgi/content/full/92/23/1876 in 1999 with Children's Cancer Group (CCG) and Pediatric Oncology Group (POG), and currently has over 230 member institutions in the US, Canada, Australia, New Zealand, Netherlands, and Switzerland. COG is the largest pediatric cancer group, and 40,000 http://www.curesearch.org/our_research/index_sub.aspx?id=1523 children and young adults are currently treated on approximately 150 COG protocols. Requirements http://www.childrensoncologygroup.org/MiscellaneousPdf/3.1.1InstMmbrshp.pdf for membership as a COG institution and principal investigator include treating a minimum annual average of twelve newly diagnosed pediatric cancer cases. COG investigators must also enroll a minimum annual average of six children on COG therapeutic trials and a minimum of two children on non-therapeutic trials. Specific support http://www.childrensoncologygroup.org/MiscellaneousPdf/3.1.2ReqInstMmbrshp.pdf specialists and facilities must also be provided in COG institutions. Every pediatric oncology patient treated at COG hospitals must be registered in the COG database, even if they are not treated on a COG protocol.

A group of investigators specializing in neuroblastoma at 13 institutions comprise the New Approaches to Neuroblastoma Therapy http://www.nant.org (NANT) consortium. This group plans and offers phase I and phase II trials for refractory and relapsed neuroblastoma only (no frontline therapies).

The various study groups (COG, GPOH, E-SIOP, etc) each have protocols used to treat each risk group of neuroblastoma. Some COG institutions enroll patients on their own "in-house" trials. These are often called pilot studies, and occasionally include more than one institution. Memorial Sloan Kettering (MSK) http://www.mskcc.org/mskcc/html/62094.cfm , Children's Hospital of Philadelphia (CHOP) http://www.chop.edu/consumer/jsp/division/generic.jsp?id=77780 , Dana-Farber Cancer Institute (DFCI)/Boston Children's http://www.childrenshospital.org/az/Site1084/mainpageS1084P0.html , Chicago's Children's Memorial Hospital (CMH) http://www.childrensmemorial.org/depts/cancer/neuroblastoma1.aspx and St Jude’s http://www.stjude.org/stjude/v/index.jsp?vgnextoid=72df722d99f70110VgnVCM1000001e0215acRCRD&vgnextchannel=85e0bfe82e118010VgnVCM1000000e2015acRCRD are all notable examples of this. The institutional studies are possible because of the relatively large number of neuroblastoma cases they treat.

General rationale for current therapies--resources

Advances in the Diagnosis and Treatment of Neuroblastoma http://theoncologist.alphamedpress.org/cgi/content/full/8/3/278 Joanna L. Weinstein, Howard M. Katzenstein, Susan L. Cohn. The Oncologist, Vol. 8, No. 3, 278–292, June 2003

High-Risk Neuroblastoma: Beyond Intensification to Novel Therapy Approaches to Improve Outcome http://www.ipcr.us/dl/ASCO_ED_Neuroblastoma2005.pdf ASCO 2005 presentation by K. Matthay, CP Reynolds, R Versteeg

Risk-based Treatment for Children with Neuroblastoma http://www.cure4kids.org/private/courses_documents/m_148/DeBernardai_Bruno.pdf SIOP 2005 presentation by Bruno De Bernardi and Susan L. Cohn

Reduction From Seven to Five Cycles of Intensive Induction Chemotherapy in Children With High-Risk Neuroblastoma http://www.jco.org/cgi/content/full/22/24/4888 Brian H. Kushner, Kim Kramer, Michael P. LaQuaglia, Shakeel Modak, Karima Yataghene, Nai-Kong V. Cheung. Journal of Clinical Oncology, Vol 22, No 24 (December 15), 2004: pp. 4888-4892

ASCO 2007 presentations by S. Kreissman, J. Park, NK Cheung, J. Maris Pediatric Cancer I http://www.asco.org/portal/site/ASCO/menuitem.64cfbd0f85cb37b2eda2be0aee37a01d/?vgnextoid=09f8201eb61a7010VgnVCM100000ed730ad1RCRD&vmview=vm_session_presentations_view&index=y&confID=47&trackID=10&sessionID=394 and Education Session Recent Advances in Biology and Therapy http://www.asco.org/portal/site/ASCO/menuitem.64cfbd0f85cb37b2eda2be0aee37a01d/?vgnextoid=09f8201eb61a7010VgnVCM100000ed730ad1RCRD&vmview=vm_session_presentations_view&index=y&confID=47&trackID=10&sessionID=222

Neuroblastoma http://www.ncbi.nlm.nih.gov/pubmed/17586306?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum John M Maris, Michael D Hogarty, Rochelle Bagatell, Susan L Cohn. Lancet, 369: 2106–20, June 23, 2007

Text reference:

Cheung NK and Cohn SL eds. Neuroblastoma. Springer: Berlin (2005)

DMLudwinski (talk) 16:33, 2 January 2008 (UTC)

I did notice the reference for #34 ^ "Painkiller Helps Against Child Cancer", medicalnewstoday.com, February 8, 2007, accessed March 8, 2007 (source apparently is a press release from the Karolinska Institutet in Sweden) didn't list the PMID http://www.ncbi.nlm.nih.gov/pubmed/17289900?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

DMLudwinski (talk) 18:19, 2 January 2008 (UTC)

One more thing! Opsoclonus myoclonus syndrome should be included under diagnosis or symptoms DMLudwinski (talk) 18:32, 2 January 2008 (UTC)

[edit] Good Article nomination

GA review (see here for criteria)
  1. It is reasonably well written.
    a (prose): b (MoS):
  2. It is factually accurate and verifiable.
    a (references): b (citations to reliable sources): c (OR):
  3. It is broad in its coverage.
    a (major aspects): b (focused):
  4. It follows the neutral point of view policy.
    Fair representation without bias:
  5. It is stable.
    No edit wars etc.:
  6. It is illustrated by images, where possible and appropriate.
    a (images are tagged and non-free images have fair use rationales): b (appropriate use with suitable captions):
  7. Overall:
    Pass/Fail: