Neuroblastoma (NB), the most common extracranial solid tumor in children, originates from embryonic neural crest cells. It accounts for 8–10% of pediatric malignancies but contributes to 15% of childhood cancer deaths . Its biological behavior is highly heterogeneous:
1. Dual Nature of Regression and Progression: Spontaneous regression occurs in ~2% of cases, while high-risk patients often develop bone marrow, skeletal, or distant metastases, with a 5-year survival rate below 50% .
2. Molecular Heterogeneity: Driver mutations such as MYCN amplification (20–30% of cases), 11q deletion, and TERT abnormalities lead to vastly divergent prognoses .
3. Diagnostic Complexity: Traditional biomarkers like 24-hour urinary vanillylmandelic acid (VMA) and serum neuron-specific enolase (NSE) lack sensitivity, necessitating integration with imaging and molecular profiling .
The International Neuroblastoma Risk Group (INRG) classification system stratifies patients into four risk categories (very low to high risk) based on age (<18 months), stage, MYCN status, and other factors . However, high-risk patients still face poor outcomes despite intensive therapies, underscoring the need for innovative approaches.
For high-risk NB, conventional chemotherapy often fails. Prof. Tang's team pioneered high-dose chemotherapy (HDC) combined with autologous stem cell transplantation (ASCT):
CDV (Cyclophosphamide/Daunorubicin/Vincristine) and CiE (Cisplatin/Etoposide) alternating regimens induced complete remission in 13/28 stage IV patients, achieving a 4-year disease-free survival (DFS) rate of 29.2%.
Post-transplant maintenance with 13-cis retinoic acid extended median recurrence-free survival to 4.1±0.7 years, with some patients surviving over 20 years.
1. MYCN Suppression Strategies:
Matrine, a traditional Chinese herbal compound, inhibited MYCN mRNA expression by 44.6% and blocked tumor cell proliferation in LA-N-5 models.
Folate receptor-targeted siRNA liposomes reduced tumor growth by 48.7% in animal models, offering a novel gene therapy approach.
2. Chemokine Pathway Modulation:
Identified CXCR4 overexpression as a marker of metastasis. Chemotherapeutics like cyclophosphamide (CTX) and pirarubicin (THP) enhanced sensitivity by downregulating CXCR4 and immunosuppressive factor Foxp3.
Collaborated with USC's Prof. Stuart Siegel to introduce IL-15/GM-CSF-activated NKT cell therapy, demonstrating potent tumor-killing effects in vitro.
Promoted a multidisciplinary model (surgery + radiotherapy + biotherapy + targeted drugs), raising 5-year survival rates for high-risk NB to 63% .
1. Bone Marrow Micrometastasis Detection:
Established immunohistochemistry-based methods with 100% sensitivity for early detection of minimal residual disease.
2. Prognostic Biomarker Panels:
Validated Ki-67 >25% as an independent poor prognostic marker, refining the INRG system.
Developed quantitative RT-PCR for MYCN mRNA to guide risk-adapted therapy.
1. Localized Protocol Optimization:
Adapted U.S. Children's Oncology Group (COG) regimens to reduce toxicity in Chinese patients, emphasizing dose intensity adjustments.
Led the "Expert Consensus on Pediatric Neuroblastoma Diagnosis and Treatment", standardizing care in China.
2. Relapse and Resistance Mechanisms:
Proposed extending maintenance therapy to 3 years and exploring second transplants for late relapses (>1 year post-remission) .
Linked MYCN amplification to telomerase length, suggesting combined TERT/ALT testing for recurrence prediction .
Published 10+ SCI papers, secured 2 National Natural Science Foundation grants, and received military medical awards.
Advocated "N+1" multidisciplinary teams (MDT) in Beijing Jingdu Children's hospitals, integrating hematology, genetics, and rehabilitation for complex cases.
Pushed for clinical trials on GD2 monoclonal antibodies (e.g., dinutuximab), ALK inhibitors, and CAR-T therapies.
Over three decades, Prof. Suoqin Tang has transformed NB treatment from chemotherapy-centric approaches to a precision medicine framework integrating molecular profiling, targeted therapy, and immunotherapy. His work bridges translational research and clinical practice, exemplified by:
1. CXCR4 Pathway Translation: Mechanistic insights directly informed chemotherapy sensitization strategies.
2. Global-Local Synergy: Adapting international protocols (e.g., IL-15/GM-CSF therapy) while incorporating traditional medicine.
3. Legacy of Collaboration: Establishing MDT as the gold standard for pediatric solid tumors.
Future advancements in liquid biopsy, epigenetic modulation, and tumor microenvironment targeting (e.g., Netrin-1/Neogenin-1 axis) promise further gains. Prof. Tang's foundational work on MYCN suppression and immune activation positions China at the forefront of NB research, offering hope to conquer this "emperor of pediatric cancers."
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