Comparative evidence on the independent contribution of granulocyte-macrophage colony-stimulating factor to anti-GD2 immunotherapy in neuroblastoma: a systematic review and gap analysis.

What was studied

This review asked what GM-CSF adds to anti-GD2 immunotherapy in neuroblastoma. It also looked for gaps in the evidence. In February 2026, the team searched EMBASE, the Cochrane Library and MEDLINE via PubMed. They also searched society websites. They looked for studies that compared anti-GD2 therapy with and without GM-CSF. The review followed PRISMA guidelines.

What they found

No study directly compared regimens that differed only by GM-CSF. A pair of studies gave only indirect, regimen-level information. Both used older antibodies that are not licensed, m3F8 and 14.G2a. Neither tested GM-CSF with licensed anti-GD2 antibodies. In a retrospective study, survival differed across treatment eras. But GM-CSF came with 13-cis-retinoic acid, and groups also differed in other ways. So the survival gaps cannot be put down to GM-CSF. An early-phase study was built to find doses and check toxicity. Its groups were very small and mixed. It did not isolate GM-CSF. No comparative study was found for dinutuximab, dinutuximab beta or naxitamab.

What it means for patients

The authors say current comparative evidence cannot show what GM-CSF adds to efficacy or safety. They say the findings give no basis to change licensed anti-GD2 regimens. They say a randomized trial holding the anti-GD2 backbone fixed is needed.

Why it is not certain yet

Only a pair of studies were relevant, and both were indirect. They used older antibodies. A review can only be as good as the studies in it.

Source

Comparative evidence on the independent contribution of granulocyte-macrophage colony-stimulating factor to anti-GD2 immunotherapy in neuroblastoma: a systematic review and gap analysis.

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