In vivo destruction of NB cells by T-cell recognition, antibody-facilitated recognition, or recognition via cells of the innate immune system have proven effective in pre-clinical murine models. Anti-tumor benefit is likely to be maximized when applied at the time of minimal tumor burden. Unfortunately,to achieve a minimal disease state, intensely immunosuppressive chemotherapy and radiotherapy are often required, which predictably compromise the patient's immune competence. As such, immunotherapeutic interventions for NB during or immediately after induction therapy may not be able to rely on the host's endogenous immune repertoire. Passive immunotherapy, whether antibodies or adoptive cell therapy, is likely to be necessary during this initial immune recovery period. Following immune recovery, active im-munotherapy may stand a better chance to be successful. Finally, to overcome immune resistance, multiple immune interventions may need to be combined.
Acknowledgements. This work was supported in part for N.K.C. by NIH grants (CA106450, CA96321, CA95742), DOE (95ER62039), Robert Steel Foundation, Hope Street Kid Foundation, Katie's Find A Cure Fund, The Katie Hoch Foundation, Pediatric Cancer Foundation, The Justin Zahn Foundation for Childhood Cancer Research, The Evan T.J. Dunbar Neu-roblastoma Foundation, and the Enid A. Haupt Endowed Chair; and for P.M.S. by grants from the NIH (CA32685, CA14520), Army (BC990300), the Midwest Athletes for Childhood Cancer, the UW GCRC (RR03186), the Children's Oncology Group (CA30969).
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