Monoclonal Antibody Therapy Plus Etoposide in Treating Patients With Neuroblastoma

DISEASE CHARACTERISTICS:

• High-risk neuroblastoma by:

  • Histopathology OR
  • Bone marrow involvement plus elevated urinary catecholamines

• Prior tumor progression on standard chemotherapy and poor long-term prognosis as indicated by 1 or more of the following:

  • N-myc amplification in tumor cells
  • Diploid chromosomal content plus lp loss of heterozygosity in tumor cells
  • Distant skeletal metastases
  • Unresectable primary tumor infiltrating across the midline
  • More than 10% tumor cells in bone marrow
  • Less than 30% chance of long-term progression-free survival
• Evaluable (microscopic marrow metastasis, elevated tumor markers, abnormal bone scan or MIBG or PET scan) but not measurable (CT scan, MRI) disease documented at least 4 weeks after completion of prior systemic therapy

• No rapidly progressive disease as defined by 1 or more of the following:

  • Serum lactic dehydrogenase greater than 1.5 times upper limit of normal due to tumor
  • An opiate requirement for pain from tumor
  • Greater than 25% increase in tumor by successive imaging studies
  • Life expectancy less than 8 weeks
• Second or subsequent remission after chemotherapy and/or radiotherapy allowed provided there is less than 30% chance of survival
• No prior myelodysplastic syndromes or leukemia

PATIENT CHARACTERISTICS:

Age:

• Not specified

Performance status:

• Not specified

Life expectancy:

• See Disease Characteristics
• At least 8 weeks

Hematopoietic:

• Not specified

Hepatic:

• No grade 3 or worse liver toxicity

Renal:

• No grade 3 or worse renal toxicity
• Creatinine clearance at least 60 mL/min

Cardiovascular:

• No grade 3 or worse cardiac toxicity

Pulmonary:

• No grade 3 or worse pulmonary toxicity

Other:

• Not pregnant
• No grade 3 or worse gastrointestinal toxicity
• No grade 3 or worse neurologic system toxicity
• No grade 4 hearing deficit
• No active life-threatening infection
• No prior exposure to mouse antibodies and human anti-mouse antibody greater than 1,000 ELISA units/mL
• No allergy to mouse proteins

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• See Disease Characteristics

Endocrine therapy:

• Not specified

Radiotherapy:

• See Disease Characteristics

Surgery:

• See Disease Characteristics