{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T01:32:15Z","timestamp":1781314335564,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with high\u2010risk neuroblastoma who either are refractory to induction chemotherapy or relapse following multi\u2010modal treatment have a dismal prognosis. Based on data from the BEACON trial, since 2021 the UK national guidelines recommend bevacizumab, irinotecan, and temozolomide (BIT) for patients with relapsed\/refractory disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective UK national study of patients under 25\u00a0years with relapsed\/refractory neuroblastoma treated with BIT 1\/3\/2021\u201028\/02\/25.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010six patients were included from 15 UK centres; 40 (61%) had relapsed disease, 23 at first relapse. Overall objective response rate was 40.6% [95% CI: 28.5%\u201353.6%] and was higher in patients with refractory versus relapsed disease (56% vs. 31%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.068). Objective responses were achieved within six cycles for over 90%. Seventeen of 26 (65%) patients with primary refractory disease received high\u2010dose chemotherapy with busulfan\/melphalan and autologous stem cell rescue. Nine required additional therapies after BIT before they could proceed to high\u2010dose treatment, and eight required BIT alone. Progression\u2010free survival (PFS) and overall survival (OS) were significantly longer in refractory patients (median PFS 13.2 vs. 5.1\u00a0months,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.012, median OS not reached by 3\u00a0years vs. 12.5\u00a0months,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0003). The most common CTCAE5.0 Grade 3\u20134 toxicities were anaemia (32%), neutropenic fever (23%) and diarrhoea (13.6%). One patient discontinued treatment due to toxicity (diarrhoea).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The promising efficacy and tolerability of BIT reported by the BEACON trial are reproduced in real\u2010world data with a larger cohort. Further randomised studies are needed to separately identify optimal treatment strategies for relapsed and refractory disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70226","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T05:14:52Z","timestamp":1773724492000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Efficacy and Safety of Bevacizumab\/Irinotecan\/Temozolomide (BIT) for Relapsed\/Refractory Neuroblastoma: The UK Children's Cancer and Leukaemia Group Experience"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1669-6666","authenticated-orcid":false,"given":"Thomas J.","family":"Jackson","sequence":"first","affiliation":[{"name":"UCL GOS Institute of Child Health  London 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UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"King","sequence":"additional","affiliation":[{"name":"Sheffield Children's Hospital  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Fathani","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanche","family":"Lumb","sequence":"additional","affiliation":[{"name":"Royal Manchester Children's Hospital  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Pobischan","sequence":"additional","affiliation":[{"name":"Leeds Children's Hospital  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irum Latif","family":"Memon","sequence":"additional","affiliation":[{"name":"Alder Hey Children's Hospital  Liverpool 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