Abstract

Neuroblastoma, an aggressive neural crest-derived malignancy of infants and young children, accounts for a large proportion of all pediatric cancer mortality, with overall survival less than 50% for high-risk disease. Current chemotherapy regimens are administered according to a risk stratification incorporating age, stage, histology, and amplification of the MYCN oncogene as primary factors for outcome (1). However, within the highest-risk group outcome is highly variable, and additional approaches are needed to identify those patients who would benefit from alternative therapies. In an article in PNAS entitled “A functional MYCN signature predicts outcome in neuroblastoma irrespective of MYCN amplification” (2), Valentijn et al. present an analysis distinguishing a subset of patients with high MYC protein levels but lacking MYCN gene amplification or high mRNA levels. They identify a set of MYCN-regulated genes in these patients regulating cell cycle, DNA repair, and apoptotic pathways and that are predictive of poor outcome.

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