The researchers suggest from these findings that dinutuximab beta and isotretinoin without subcutaneous IL-2 should thus be considered the standard of care until results of ongoing randomised trials using a modified schedule of dinutuximab beta and subcutaneous IL-2 are available.
According to a commentary, one important caveat is that only 62% of the patients randomly assigned to the IL-2 group received their assigned therapy, mainly because of toxicity, compared with 87% of patients receiving dinutuximab alone, and the absence of improved outcome might be attributed to under-dosing. Furthermore, whether the addition of GM-CSF alone or in combination with IL-2 would improve event-free survival, or if a change in IL-2 administration schedule would affect outcome, has not been established. It notes that future trials to improve efficacy of anti-GD2 therapy will investigate other activators for cytotoxicity combined with anti-GD2, including lenalidomide, chemotherapy,radiolabelled anti-GD2, activated natural killer cells, or GD2 chimeric antigen receptor T cells.