The New Biology of Enigmatic Neuroblastoma and Relevant Treatment Strategies
Forum Chairs
Forum Description
Neuroblastoma remains the most frequent solid abdominal and thoracic malignancy of childhood, a tumor characterized by an aggressive behavior and a dismal outcome. Therapeutic strategies have historically emphasized aggressive multimodal therapy, and the marginal improved prognosis seen in the last several years has depended on the acceleration and further intensification of such treatment. Such a strategy is contradictory to the observation that the diagnosis of low stage neuroblastoma is possible by mass population screening, and low stage patients have a worse outcome in the face of more aggressive therapy. Furthermore, despite its poor prognosis, neuroblastoma is that tumor characterized by two uniquely enigmatic, yet favorable, behaviors. First, it can spontaneously or by exogenous manipulation be stimulated to change its phenotype from an aggressive and metastasizing malignancy to a mature and benign ganglioneuroma. Second, it has the potential to undergo spontaneous regression, and even frank disappearance, despite an original large and even disseminated tumor burden. As investigators have sought to understand this biological behavior, a series of specific areas of investigation have evolved that will serve as the focus for this meeting. They include a delineation of the immunobiology of neuroblastoma, a definition of signaling mediators, receptors, and their mechanisms, the study of angiogenesis, angiogenic inhibitors, and their potential linkage to signaling as well as the immune response, and the investigation of the genetic analysis of neuroblastoma as well as the putative application of gene therapy as an effector for these various treatment strategies.
Forum Summary
Signaling Mediators and their Receptors: Fundamental mechanisms of signaling under intense study in neuroblastoma continue to explore those pathways that might contribute to our understanding of the enigmatic behavior of this tumor, where on the one hand it is characterized by aggressive growth, resistant to many conventional anticancer therapies while on the other hand it can spontaneously, or in response to therapy, undergo maturation into a benign phenotype or even undergo a regression characterized by disappearance. Michael P. LaQuaglia, MD (Memorial Sloan-Kettering Cancer Center) addressed the use of histone deactylase (HDAC) inhibitors as a potential novel anti-neuroblastoma therapy. Dai H. Chung, MD (University of Texas, Galveston) described the relationship of gastrointestinal hormones to neural crest tumors that produce vasoactive intestinal peptide (VIP), gastrin and somatostatin. In related work, Dr. Chung has also studied the antitumor activity of the benzoquinone ansamycin antibiotic geldanamycin (GA), an agent that decreases the viability of neuroblastoma cells and increases apoptotic cell death. Garrett M. Brodeur, MD (Children’s Hospital of Philadelphia) described an update of his ongoing work that has defined the regulatory role of the neurotrophins on neuroblastoma growth. Thomas H. Inge, MD, Ph.D. (Cincinnati Children’s Hospital Medical Center) described studies of the novel anthracycline antibiotic analog of doxorubicin (Dox) WP744. Jeff C. Hoehner, MD, Ph.D. (Johns Hopkins University) described the microenvironment of neuroblastomas focusing on the hypoxic tumor cell that proliferates poorly and is more prone to resistance to both chemotherapy and radiotherapy.
Gene Analysis and Therapy: Jed G. Nuchtern, MD (Baylor College of Medicine) reported on work that has focused on the helix loop helix nuclear transcription factor MYCN, a protein whose amplification is linked to the malignant neuroblastoma phenotype. Though Akita Nakagawara, MD, Ph.D. (Chiba Cancer Center Research Inst, Japan) was unable to attend, he submitted a summary of his recent application of comprehensive genomics to the study of neuroblastoma. Andrew Davidoff, MD (St. Jude Children’s Research Hosp) reported on the application of gene therapy for the antiangiogenic therapy of neuroblastoma utilizing an adeno associated virus vector. Interestingly, in an effort to further enhance anti-tumor activity, an increased dose of vector and transgene was administered, and a paradoxical acceleration of tumor growth was observed. Dr. M. Judah Folkman, (Harvard Medical School) commented that this was the classic dose-response “U-shaped curve” seen with other angiogenesis inhibitors and their anti-tumor activity, and that Dr. Davidoff has now demonstrated this phenomenon at the gene level. A. Thomas Look, MD (Harvard Medical School) described his research into the genetics of neuroblastoma using the novel zebra fish model.
Immunology and Immunotherapy: Edward M. Barksdale. Jr., MD (University of Pittsburgh) presented his ongoing work of dendritic cell therapies for advanced neuroblastoma. Anthony Sandler, MD (University of Iowa) hypothesized that an effective neuroblastoma vaccine strategy would target and directly stimulate signaling pathways that would further amplify tumor antigen-specific immune responses. James Geiger, MD (University of Michigan) reported on his efforts to translate dendritic cell therapy to the clinical realm.
Venue & Travel Information
Travel Policy
Please familiarize yourself with our policies and procedures for travel. We truly appreciate you taking the time to participate in this forum. As you make your plans, please remember that we are a nonprofit organization dependent on donations and volunteers. We do NOT pay for upgrades, change fees, incurred costs resulting from a flight change, transportation to or from your local (home side) airport, meals or other incidentals.
- Travel Confirmation will be sent out within 1 week of the forum. This will include a hotel confirmation number, if there is one, and airport transfer details. We have to wait until we receive almost everyone’s travel to book airport transfer. Due to frequent airline changes, we wait until the week of the forum to send this out.
- Airport transfer is provided by Foundation staff, volunteers or arranged shuttle at specific times. If you opt to utilize Foundation airport transportation on your travel form, please be patient in receiving this information. We will send it to the week of the forum.
- Speaker agenda is not sent out prior to the forum. It will be provided upon arrival in the forum packet. We do not tell people when they are speaking because we expect everyone to attend all sessions. Sessions are all day Friday and Saturday.
- REMINDER: We do not reimburse for home side airport transfer or incidentals while traveling. We will not honor miscellaneous receipts sent for these expenses.
- Spouses are welcome to come with you at their own cost but are not allowed to attend the forum. Please no children.
What the Foundation Pays
Accommodations and meals are provided by the foundation during the forum. Airfare will be covered only if booked through our travel agent. The Foundation will also cover airport transportation on the forum side at the designated shuttle times. You can select not to utilize Foundation arranged transportation at your own expense when completing the travel form. Once your travel form is received your accommodations and airport transfer will be confirmed. Please let us know of any food allergies or other information we should be aware of on the travel forms.
- If you would like your airfare covered by the Foundation, you must book with our travel agent. Note we do not cover upgrades, changes, late bookings, etc.
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- As a nonprofit we utilize volunteers and other methods to maximize our efforts (or our donor support) when making accommodations and arranging ground transportation. Ground transportation will be provided upon your arrival either by a foundation volunteer or arranged shuttle. You will be provided airport transportation information the week of the forum. We do not reimburse for home side airport transfer or incidentals while traveling.
Abstracts
Abstracts are due 30 days prior to the start of the meeting to allow enough time to prepare the meeting book.
The abstracts should be only one or two paragraphs outlining the theme of your presentation and should reflect the objective and spirit of the meeting (see above). Abstracts will be circulated about one week before the meeting. The meeting organizer will start requesting them a month before the meeting.
Forum Structure
The structure of the forum has been developed over years of experience.
- Participants have approximately 45 minutes, depending on the number of participants, for their presentation and discussion. The presentation is meant as a conversation start and should last about twenty minutes briefly covering background information and areas that are new or need further input. This should be structured in such a way as to lead to a lively discussion. Participants are encouraged to interrupt to ask questions or start discussions.
- A MAXIMUM of 5 slide equivalents per presentation is allowed (Power point slides should not contain more than one graph or gel per slide and no more than 5 bullet points to stress the points being made by the presenter.) We appreciate cooperation with the spirit of this guideline. Handouts are welcome but should be distributed before sessions.
- Everyone is expected to actively participate in every session and discussions.
- The time spent at the forum is relatively short, so please be familiar with papers received prior to arrival.
- It is very important that you commit to all sessions of the 2 days of the forum.
Forbeck Scholars Participation
Scholars are selected for each Forbeck Forum. These are outstanding junior clinical or post-doctoral fellows selected based on the quality and relevance of science.
- Scholars present for 30-45 minutes, depending on the number of participants
- The same presentation rules apply for scholars
- After the Forum you are selected to attend, you will attend three years of Scholar Retreats held in Lake Geneva, WI. If you attend a Fall Forum, you will attend the Spring Retreat. If you attend a Spring Forum you will attend a Fall Retreat.
- Scholars are selected by the Foundation Scientific Advisory Board and peer reviewers selected from past Forbeck Scholars.
General Program
The outline below illustrates a typical program schedule. You will receive a complete schedule, including speaking times, the Thursday the forum starts.
Frequently Asked Questions
Below are some of our most Frequently Asked Questions. If you have something new to ask, please feel free to contact us.
- Travel Confirmation will be sent out within 1 week of the forum. This will include a hotel confirmation number, if there is one, and airport transfer details. We have to wait until we receive almost everyone’s travel to book airport transfer. Due to frequent airline changes, we wait until the week of the meeting to send this out.
- Airport transfer is provided by Foundation staff, volunteers or arranged shuttle at specific times. If you opt to utilize Foundation airport transportation on your travel form, please be patient in receiving this information. We will send it to the week of the forum.
- Speaker agenda is not sent out prior to the meeting. It will be provided upon arrival in the meeting packet. We do not tell people when they are speaking because we expect everyone to attend all sessions. Sessions are all day.
- Frequently airport transfer is provided by volunteers. Please be patient on receiving this information. Airport transfer will be sent out prior to arrival.
- REMINDER: We do not reimburse for home side airport transfer or incidentals while traveling. We will not honor miscellaneous receipts sent for these expenses.