Monoclonal Antibody 3F8 and Oral Etoposide for the Treatment of Neuroblastoma

Inclusion Criteria

DISEASE CHARACTERISTICS:

- High-risk neuroblastoma by:

- Histopathology OR

- Bone marrow involvement plus elevated urinary catecholamines

- Prior tumor progression on standard chemotherapy and poor long-term prognosis as
indicated by 1 or more of the following:

- N-myc amplification in tumor cells

- Diploid chromosomal content plus lp loss of heterozygosity in tumor cells

- Distant skeletal metastases

- Unresectable primary tumor infiltrating across the midline

- More than 10% tumor cells in bone marrow

- Less than 30% chance of long-term progression-free survival

- Evaluable (microscopic marrow metastasis, elevated tumor markers, abnormal bone scan
or MIBG or PET scan) but not measurable (CT scan, MRI) disease documented at least 4
weeks after completion of prior systemic therapy

- No rapidly progressive disease as defined by 1 or more of the following:

- Serum lactic dehydrogenase greater than 1.5 times upper limit of normal due to
tumor

- An opiate requirement for pain from tumor

- Greater than 25% increase in tumor by successive imaging studies

- Life expectancy less than 8 weeks

- Second or subsequent remission after chemotherapy and/or radiotherapy allowed
provided there is less than 30% chance of survival

- No prior myelodysplastic syndromes or leukemia

PATIENT CHARACTERISTICS:

Age:

- Not specified

Performance status:

- Not specified

Life expectancy:

- See Disease Characteristics

- At least 8 weeks

Hematopoietic:

- Not specified

Hepatic:

- No grade 3 or worse liver toxicity

Renal:

- No grade 3 or worse renal toxicity

- Creatinine clearance at least 60 mL/min

Cardiovascular:

- No grade 3 or worse cardiac toxicity

Pulmonary:

- No grade 3 or worse pulmonary toxicity

Other:

- Not pregnant

- No grade 3 or worse gastrointestinal toxicity

- No grade 3 or worse neurologic system toxicity

- No grade 4 hearing deficit

- No active life-threatening infection

- No prior exposure to mouse antibodies and human anti-mouse antibody greater than
1,000 ELISA units/mL

- No allergy to mouse proteins

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Not specified

Chemotherapy:

- See Disease Characteristics

Endocrine therapy:

- Not specified

Radiotherapy:

- See Disease Characteristics

Surgery:

- See Disease Characteristics