3F8 vs. Ch 14.18 antibody for Neuroblastoma stage 4
My daughter has Neuroblastoma (Stage 4) MYCN amplified. She is currently undergoing MSKCC's treatment protocol, administered by our doctor in Singapore (where we have come to do treatment). We have a key decision to make. Basically we have the following two options:
1. Stay in Singapore, and do a Myeloablative chemotherapy - which is high dose, and has its own side effect risks - followed by a stem cell (bone marrow) transplant. This is standard in most of the world (except the MSK hospital in New York it seems - see option 2). After this, she can receive an antibody (Unituxin (dinutuximab), or Ch14.18) that has just come to Singapore this year (2016), which increases cure rate to around 60% in other parts of the world.
2. OR - she skips the Myeloablative chemotherapy - and skips the BMT. She goes on to MSK (New York) to do radiotherapy and 3F8 antibody treatment. The key difference here is that she skips a couple of major standard processes, which is a major advantage. The disadvantages are cost, logistics (we have never been to the US so visas etc.), and generally the move will require us (parents and child) to settle down in a new place. The cure rate seems to be about the same at 60+%.
I have heard that one doctor here believes in stem cell transplant with the antibody here, but anyways, the standard seems to be doing option 1, except at MSK (option 2) where they have a patented antibody (3F8) of their own, without the BMT.
The advantage largely outweighs the disadvantages. However, we want her to be cured, of course, so there's no easy decision since the numbers above are probabilities and not guarantees.
Can anyone share any similar experience, if your child went through option 1 or 2? Did you have a choice at the time, where did you do your treatment, and would you like to share your story? My wife and I are very keen on reaching out to anyone who has been through either of these types of treatment, which will weigh in on our decision.
Thanks very much!