InPHOG-NB-23-02

Indian Cooperative Neuroblastoma Study: Non-high risk (ICONS-18)

PI : Dr. Yamini Krishnan

Institution : MVR, Kozhikode Kerala

About the Study

Focuses on children with low- and intermediate-risk neuroblastoma, using a standardized risk stratification approach based on clinical and biological factors. The study aims to optimize treatment—ranging from observation to surgery and chemotherapy—while improving survival outcomes and ensuring uniform care across centres in India.

Aim of the Study

Primary objective is to utilize a uniform staging system, that includes age, stage, pathology and limited genomic testing, to accurately risk stratify patients with neuroblastoma in India, and to document >80% 3-year overall survival outcomes for patients with the following :

Very low-risk neuroblastoma treated with observation alone.
Low-risk neuroblastoma treated with observation or surgery only.
Low-risk neuroblastoma and life-threatening symptoms treated with chemotherapy.
Intermediate-risk neuroblastoma treated with chemotherapy and surgery.

Eligibility Criteria

Inclusion Criteria

All newly diagnosed patients with confirmed low-risk and intermittent-risk neuroblastoma, seen at participating institutions are eligible for this study.
All patients and/or their parents or legal guardians must sign a written informed consent with age-appropriate child assent.

Exclusion Criteria

Patients who are high risk i.e. they have tumors with MYCN amplification or have metastatic disease and are over 12 months of age or are 12-18 months of age with documented SCA, are excluded from this protocol.
Patients with ganglioneuroma are excluded.
Absent informed consent and age-appropriate assent.
In the case of children who have received chemotherapy for LTS there is no documentation of the chemotherapy received or the child has received more than 2 cycles of chemotherapy.