Managing Adverse Events Associated with Dinutuximab Beta Treatment in Patients with High-Risk Neuroblastoma: Practical Guidance

Giuseppe Barone, Ailish Barry, Francisco Bautista, Bénédicte Brichard, Anne-Sophie Defachelles, Fiona Herd, Carla Manzitti, Dirk Reinhardt, Pedro M Rubio, Aleksandra Wieczorek, Max van Noesel, Paco Bautista Sirvent

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)


Neuroblastoma is the most common extracranial solid tumour in children, accounting for 15% of all paediatric cancer deaths. High-risk neuroblastoma is a particularly challenging-to-treat form of disease that requires multimodality treatment, consisting of chemotherapy, surgery, high-dose chemotherapy with autologous haematopoietic stem cell rescue, radiotherapy and differentiation therapy. However, despite intense multimodal treatment regimens, the prognosis for this patient population remains poor. In recent years, immunotherapy with anti-disialoganglioside 2 (anti-GD2) antibodies was found to improve survival rates for patients with high-risk neuroblastoma. Based on studies led by the SIOPEN (International Society of Paediatric Oncology European Neuroblastoma) group, the anti-GD2 antibody dinutuximab beta was approved for use in high-risk neuroblastoma by the European Medicines Agency and has been implemented into the standard of care in many countries across Europe. However, immunotherapy with dinutuximab beta is associated with a number of adverse events that may be challenging for clinicians, such as pain, fever, hypersensitivity reactions and capillary leak syndrome. While these adverse events are considered manageable, there are currently no formal guidelines to support clinicians with their management. The aim of this article is to discuss the management of the most common adverse events encountered in clinical practice and to provide practical guidance to assist clinicians in minimising toxicity associated with dinutuximab beta.

Original languageEnglish
Pages (from-to)537-548
Number of pages12
JournalPaediatric drugs
Issue number6
Publication statusPublished - Sept 2021


  • Antibodies, Monoclonal/adverse effects
  • Humans
  • Immunologic Factors
  • Immunotherapy/adverse effects
  • Neuroblastoma/drug therapy


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