Navigating 131I-MIBG and CAR T 19, in COG trials ANBL1531 and AALL1721: Sharing Care and Strategies for Success (C205)

3:45–4:45 pm Thursday, September 5

coglogoThe Children’s Oncology Group (COG) is committed to improving outcomes for pediatric oncology patients with the high-risk disease through clinical trials. Despite tremendous advancements in pediatric oncology treatment, survival in two patient populations remains inferior. Patients with high-risk neuroblastoma have a projected 3-year event-free survival of 73% (Park et al., 2016), and patients with precursor B lineage acute lymphoblastic leukemia with positive minimal residual disease at the end of consolidation have a projected 5-year disease-free survival of 39% (Borowitz et al., 2015).

Two recent COG trials are focused on improving the survival rates for these patients: ANBL1531 includes administration of 131 I-Metaiodobenzylguanidine (131I-MIBG) and AALL1721 includes administration of Tisagenlecleucel, chimeric antigen receptor T cell (CAR T) directed at CD 19. Currently, administration of the investigation therapies on these trials is available at limited institutions that have received training and have necessary resources. Administration of these treatments occurs early in the cancer journey. The timing and complexities of these therapies come with an added burden for many families who will need to travel and relocate to a designated site. The patient and family will be cared for by a new team of healthcare providers, adding to an overwhelming experience, requiring significant resources and support. Appropriate education and anticipatory guidance to prepare the patient and family can help reduce distress and establish trust with the healthcare providers they will encounter at two different centers (Thompson & Young-Saleme, 2015). During this session, we will provide highlights of the clinical trial design for ANBL1531 and AALL1721 and explore strategies for effectively partnering in care and communicating between treatment centers. Prior experience with patients and families receiving 131I-MIBG and CAR T cell therapy will be shared, focusing on successful approaches to provide families’ information and anticipatory guidance to support their experience.