Dinutuximab beta

How it works

It binds the GD2 disialoganglioside expressed on neuroblastoma cells and triggers antibody-dependent cellular cytotoxicity and complement-dependent cytotoxicity, leading to immune-mediated tumour cell killing.

Prescribing in practice

• Severe neuropathic pain is expected during infusion and requires planned analgesia, and infusion-related and hypersensitivity reactions can be serious, so it is given only in specialist paediatric oncology centres with full support.
• Capillary leak syndrome and ophthalmological disorders are recognised adverse effects requiring vigilance.
• For all dosing in children, follow a children's formulary and the SPC rather than extrapolating adult regimens.

Monitoring

Monitor closely during infusion for pain, infusion reactions, capillary leak syndrome, blood pressure and neurological and ophthalmic status.

Counselling the patient

• Pain during the infusion is expected and pain relief will be given in advance.
• Tell the team immediately about eye problems, swelling or breathing difficulty.

Evidence & guidelines

Dinutuximab beta is recommended within its licensed indication for high-risk neuroblastoma based on improved outcomes in clinical trials.