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Peer-reviewedCC BYOncology reviews

The role of personalised medicine in treating high-risk neuroblastoma in paediatric patients.

  1. 1Department of Translational and Advanced Diagnostics, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Trieste, Italy.
  2. 2Department of Pediatrics, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Trieste, Italy.

Abstract

Neuroblastoma (NB) is one of the most challenging paediatric malignancies, accounting for 15% of childhood cancer-related deaths. It is characterised by a high heterogeneity ranging from spontaneous regression to high frequency of metastatic disease at diagnosis. Although current treatment strategies, including chemotherapy, surgery and radiotherapy, have improved outcomes, recurrence often occurs in high-risk NB patients, thus affecting overall survival. In this context, personalised medicine is emerging as a promising approach taking advantage of predictive biomarkers to refine risk stratification and to predict treatment response, together with the development of innovative treatments for high-risk NB. This review summarises the landscape of biomarkers in NB, focusing on genomic, transcriptomic, proteomic, and metabolomic signatures associated with aggressive disease biology, therapeutic resistance, and clinical outcome. We highlight how improved patient stratification could help to identify actionable targets resulting in innovative therapeutic strategies. These include GD2-directed immunotherapy, CAR-T and CAR-NK cell approaches, and pathway-directed agents targeting mainly ALK, and MYCN-associated dependencies. Ultimately, the transition from standardised protocols to a systematic integration of multidimensional biomarker profiles with next-generation therapies promises to transform the clinical management of high-risk NB. Addressing the biological complexity of NB ensures more effective and less toxic interventions, paving the way for personalised therapeutic approaches aimed at preventing relapse in high-risk cases and significantly improving long-term survival.

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BibTeX
@article{ammeti2026role,
  title = {{The role of personalised medicine in treating high-risk neuroblastoma in paediatric patients.}},
  author = {Daniele Ammeti and Debora Curci and Martina Franzin and Marco Rabusin and Melania Eva Zanchetta and Antonella Fabretto},
  journal = {Oncology reviews},
  year = {2026},
  month = oct,
  doi = {10.3389/or.2026.1850627},
  url = {https://europepmc.org/article/MED/42909156},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - The role of personalised medicine in treating high-risk neuroblastoma in paediatric patients.
AU  - Daniele Ammeti
AU  - Debora Curci
AU  - Martina Franzin
AU  - Marco Rabusin
AU  - Melania Eva Zanchetta
AU  - Antonella Fabretto
PY  - 2026
DA  - 2026/10/07
JO  - Oncology reviews
DO  - 10.3389/or.2026.1850627
UR  - https://europepmc.org/article/MED/42909156
AB  - Neuroblastoma (NB) is one of the most challenging paediatric malignancies, accounting for 15% of childhood cancer-related deaths. It is characterised by a high heterogeneity ranging from spontaneous regression to high frequency of metastatic disease at diagnosis. Although current treatment strategies, including chemotherapy, surgery and radiotherapy, have improved outcomes, recurrence often occurs in high-risk NB patients, thus affecting overall survival. In this context, personalised medicine is emerging as a promising approach taking advantage of predictive biomarkers to refine risk stratification and to predict treatment response, together with the development of innovative treatments for high-risk NB. This review summarises the landscape of biomarkers in NB, focusing on genomic, transcriptomic, proteomic, and metabolomic signatures associated with aggressive disease biology, therapeutic resistance, and clinical outcome. We highlight how improved patient stratification could help to identify actionable targets resulting in innovative therapeutic strategies. These include GD2-directed immunotherapy, CAR-T and CAR-NK cell approaches, and pathway-directed agents targeting mainly ALK, and MYCN-associated dependencies. Ultimately, the transition from standardised protocols to a systematic integration of multidimensional biomarker profiles with next-generation therapies promises to transform the clinical management of high-risk NB. Addressing the biological complexity of NB ensures more effective and less toxic interventions, paving the way for personalised therapeutic approaches aimed at preventing relapse in high-risk cases and significantly improving long-term survival.
SN  - 1970-5565
SN  - 1970-5557
ER  -