Naxitamab for Relapsed/Refractory Neuroblastoma

Background Children with relapsed/refractory (R/R) neuroblastoma are at risk for poor outcomes due to resistant disease. Naxitamab is an anti-glycolipid disialoganglioside (GD2) monoclonal antibody approved by the Food and Drug Administration for the treatment of R/R high-risk neuroblastoma. Serious adverse reactions are an expected part of treatment and include severe nerve pain during the infusion. Institutions using an interdisciplinary team approach can create a safe system for the infusion of naxitamab in the outpatient clinic setting. The purpose of this article is to present this immunotherapy, naxitamab, its adverse events (AEs), and one institution’s approach in administering naxitamab in an outpatient infusion center. Method An interdisciplinary team, led by a pediatric oncology advanced practice nurse, developed a detailed standardized care plan that can be tailored to the patient's previous history with pain medications and response to naxitamab. The team includes multiple nursing roles, physician specialists, pharmacists, psychosocial staff, and the patient and family; each team member is educated in their defined role. Results AEs can be effectively managed, and naxitamab infusions can be safely infused in the outpatient infusion center through repeated cycles of treatment. Patients can be discharged to home 2 hr after the completion of the infusion. Discussion Outpatient administration of naxitamab requires exact planning and implementation by a well-prepared interdisciplinary team. This approach supports patients and families in maximizing their quality of life through ambulatory care.