What is 3F8? 3F8 is the name of a substance called a monoclonal antibody. It attaches to GD2, which is a marker on the surface of neuroblastoma cells. 3F8 was produced by white blood cells of mice, and it must be carefully prepared for human use. 3F8 is part of our standard treatment for high-risk neuroblastoma and is only available at Memorial Sloan-Kettering in New York. 1. What is the theory behind antibody therapy? 2. How does 3F8 work? 3. How does the 3F8 get to neuroblastoma in patients? 4. How long have 3F8 treatments been used? 5. How is 3F8 Given? 6. What are the common side effects of 3F8? 7. Why does 3F8 cause pain? 8. What is HAMA? 9. Is HAMA good or bad? 10. Is 3F8 made at Memorial Sloan-Kettering? 11. Which patients are eligible for treatment with 3F8? 12. When should 3F8 be used in a patient? 13. Is there other treatment options for neuroblastoma at Memorial Sloan-Kettering aside from 3F8? 1. What is the theory behind antibody therapy? A person's immune system makes antibodies to attack germs such as bacteria or viruses, but it will not attack neuroblastoma because the tumor is part of our own bodies. An antibody that attaches to neuroblastoma can be made in a laboratory and then given intravenously to a patient. This antibody will circulate in the bloodstream until it finds and attaches to a neuroblastoma cell. And then the patient's own immune system will attack and kill that neuroblastoma cell. Top Back to Top 2. How does 3F8 work? When 3F8 is injected into a patient's bloodstream, it travels and attaches to the GD2 marker on neuroblastoma cells. The attachment of 3F8 to a neuroblastoma cell serves as a signal to the patient's own immune system (for example, the white blood cells) to attack the tumor cell and kill it. In other words, the 3F8 directs the patient's own immune system (which usually acts only to control infections) against the neuroblastoma. Chemotherapy weakens a lot of the immune system, but not the part that works with antibodies. With time, as the body's own immune system becomes stronger, 3F8 treatments may help the body learn to fight tumors on its own. Back to Top 3. How does the 3F8 get to neuroblastoma in patients? The team at Memorial Sloan-Kettering in New York have attached a radioactive isotope called 131-iodine (131I) to 3F8 and injected the 131I-3F8 into patients. Then, when patients are scanned (just like with a bone scan or MIBG scan), we see radioactivity (from the 131I-3F8) in areas we know contain neuroblastoma but not in other areas in the body. Back to Top 4. How long have 3F8 treatments been used? Since 1986, more than 18,000 infusions of 3F8 have been safely used in more than 400 patients. Through the years, we have learned how to use 3F8 in order to make it better for killing neuroblastoma. Back to Top 5. How is 3F8 Given? 3F8 is given intravenously (IV) over 30 minutes through a Broviac, Hickman, MediPort, or peripheral line. When being treated with 3F8, patients usually need to be in the clinic for about three hours. This period includes time for giving medicines to prevent possible side effects, the 30 minute 3F8 treatment itself, and one to two hours to monitor the patient for side effects. Back to Top 6. What are the common side effects of 3F8? Pain is the main side effect. All patients have pain. The second most common side effect is rash (hives with itching), which is an allergic reaction. Pain can lead to a fast pulse (rapid heart rate) and sometimes causes high blood pressure for a short period. Less-common side effects include fever, vomiting, and diarrhea. These problems can usually be taken care of in the outpatient clinic, but sometimes a patient needs to be admitted to the hospital for an overnight stay. In the neuroblastoma outpatient clinic at Memorial Sloan-Kettering, we routinely treat 10 to 12 patients a day with 3F8, and manage side effects of the treatment without much difficulty. Back to Top 7. Why does 3F8 cause pain? 3F8 attaches to GD2, which is present on some nerve cells as well as on neuroblastoma cells. When 3F8 attaches to a nerve cell, a message is sent to the brain, and the patient feels pain. The pain usually starts toward the middle or end of the daily 3F8 treatment and lasts a short time (usually from a few minutes up to an hour). Sometimes discomfort or minimal pain continues during the hours after the treatment. Medicines are used to prevent or control the pain (usually morphine or Dilaudid) and the allergic reactions (usually Benadryl or Vistaril). Ativan and Zofran are other medicines that can help. Patients who were treated with 3F8 beginning in 1986 have been followed, and to date, no permanent side effects on their nerves have appeared. Back to Top 8. What is HAMA? HAMA stands for "human anti-mouse antibodies." HAMA measures how strongly the body's immune system is reacting to 3F8. 3F8, like most monoclonal antibodies, comes from a mouse white blood cell. This means that 3F8 looks different from a human antibody, and a human will form antibodies (HAMA) against 3F8. If a patient has HAMA, there is no point in doing 3F8 treatments because the HAMA will block the 3F8 from getting to neuroblastoma cells. However, HAMA can disappear, and 3F8 treatments can then resume. Patients are checked for HAMA by means of a blood test. Patients with HAMA do not have pain or other side effects of 3F8 treatment, but patients without side effects sometimes do not have HAMA (and can continue to be treated with 3F8). Back to Top 9. Is HAMA good or bad? HAMA might be a sign that a patient is developing an immune response against the neuroblastoma -- and that is a good thing. It is probably best that a patient receive at least four cycles of 3F8 treatments. Most patients who have received chemotherapy only a short time before 3F8 treatment do not make HAMA because part of their immune system is too weak. In Memorial Sloan-Kettering's protocols, the aim is to give repeated treatments with 3F8 until HAMA is made. It appears that the best chances for cure are realized when multiple cycles of 3F8 treatment are given before the patient begins to form HAMA. Back to Top 10. Is 3F8 made at Memorial Sloan-Kettering? No. An outside company produces it under GMP (good manufacturing practice) conditions. Private funding is needed to pay for the production of 3F8 and to carry out tests to meet the many safety requirements of the federal government. Patients are not charged for 3F8. While government (grant) funding has been given for much of the laboratory science involved with 3F8, the government generally does not support the manufacturing process. Back to Top 11. Which patients are eligible for treatment with 3F8? 3F8 protocols are available for almost any patient who has high-risk neuroblastoma. Back to Top 12. When should 3F8 be used in a patient? It is best for a patient to start 3F8 treatment by six-to-eight weeks after transplant or after strong chemotherapy. Back to Top 13. Is there other treatment options for neuroblastoma at Memorial Sloan-Kettering aside from 3F8? There are a number of phase I and phase II studies, as well as state-of-the-art chemotherapy currently being offered at Memorial Sloan-Kettering. Several promising approaches are in the pipeline waiting to be introduced into the clinic. Back to Top |Welcome| |About Us| |Board Of Directors| |Donations| |Life Goes On| |Resources| |Supporters| |Contact Us| |Who We Have Met| |Photo Gallery| |News & Events| |Care Packs| |What Is 3F8| |Pacc's Annual Events |