{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T20:50:01Z","timestamp":1785876601384,"version":"3.56.0"},"reference-count":63,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      amplification (\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      -A) is an important prognostic marker in neuroblastoma. However, the impact of\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      -A in patients with metastasized high-risk neuroblastoma during the course of disease remains unclear. The aim of this study was to investigate response and relapse patterns of stage IV patients with and without amplification of\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS<\/jats:title>\n                    <jats:p>\n                      Amplification of the\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      oncogene was assessed by fluorescence in situ hybridization, whole exome sequencing, or single nucleotide polymorphism analysis. Complete remission (according to the revised International Neuroblastoma Response Criteria) and survival outcomes were estimated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Among the 164 patients older than 12 months with metastatic high-risk neuroblastoma, 50 (30%) had\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      -A.\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      -A was a significant prognostic marker for overall survival (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04). Patients with\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      -amplified tumors reached complete remission faster compared with those without\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      amplification (HR, 1.8 [95% CI, 1.2 to 2.8];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01).\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      -A was associated with recurrence when evaluated from diagnosis and after induction treatment (HR, 1.6 [95% CI, 1.0 to 2.4]; and HR, 1.8 [95% CI, 1.1 to 2.8], respectively), as well as to the cumulative incidence of recurrence (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03, respectively). SIOPEN scores detected on\n                      <jats:italic toggle=\"yes\">meta<\/jats:italic>\n                      -[\n                      <jats:sup>123<\/jats:sup>\n                      I]iodobenzylguanidine (MIBG) scintigraphy were significantly lower in patients with\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      -amplified tumors than in patients with\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      nonamplified tumors at diagnosis and after induction treatment (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01, respectively). From end of induction,\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      -A stratified by SIOPEN score was associated with the cumulative incidence of recurrence (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      Despite achieving complete remission faster, patients with\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      -A have a higher probability of recurrence compared with those without\n                      <jats:italic toggle=\"yes\">MYCN<\/jats:italic>\n                      -A.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/po-25-00635","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T19:59:11Z","timestamp":1773345551000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":3,"title":["Effect of\n                    <i>MYCN<\/i>\n                    Amplification on Tumor Response and Recurrence in Patients With Stage IV Neuroblastoma"],"prefix":"10.1200","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7182-3202","authenticated-orcid":true,"given":"Yvette A. H.","family":"Matser","sequence":"first","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7989-4910","authenticated-orcid":true,"given":"Andr\u00e9 B. P.","family":"van Kuilenburg","sequence":"additional","affiliation":[{"name":"Laboratory Genetic Metabolic Diseases, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6165-0902","authenticated-orcid":true,"given":"Atia","family":"Samim","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"},{"name":"Division of Imaging and Oncology, University Medical Center, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1340-5060","authenticated-orcid":true,"given":"Lotte M.","family":"van Liempt","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8849-8573","authenticated-orcid":true,"given":"Martine","family":"van Grotel","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathelijne C. J. M.","family":"Kraal","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda P.","family":"Dierselhuis","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0526-3737","authenticated-orcid":true,"given":"Natasha K. A.","family":"van Eijkelenburg","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6780-0585","authenticated-orcid":true,"given":"Karin P. 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