Neuroblastoma: Current advancements and future therapeutics

Neuroblastoma is an extracranial solid tumor commonly observed in the pediatric population. Although various management strategies have been developed over the years, its characteristic aggressiveness and its heterogeneous clinical behavior have greatly hampered therapeutic success, especially in patients with relapsed or refractory cases. Moreover, extensive use of therapeutics in these patients has also led to short-term and long-term toxicities, as well as the emergence of treatment resistance. These limitations have strongly encouraged the design and development of next-generation therapeutics to combat the disease. Recently, nanomedicine has gained increasing attention in modern medicine, as nanomedicine-based strategies can produce greater effectiveness as compared to conventional therapies. At the same time, they are found to minimize the occurrence of adverse events. In terms of neuroblastoma, various innovative drug and gene delivery strategies have been vigorously studied for their potential in disease diagnosis and treatment, whereby some of these studies have successfully shown promising outcomes. Nevertheless, the exact mechanisms and therapeutic roles of nanomedicine in neuroblastoma have yet to be fully elucidated, and most nanoformulations are only studied at the preclinical stage. Thus, further investigations, including clinical studies, are crucial to evaluate the risk-to-benefit ratio of such novel approaches. In this chapter, the advantages and limitations of conventional neuroblastoma therapeutics will be discussed, with special focus on the use of nanomedicine-based strategies with respect to their benefits.