# Discovering and Exploiting Mechanisms of Neuroblastoma Therapy Resistance

> **NIH NIH P01** · CHILDREN'S HOSP OF PHILADELPHIA · 2024 · $2,545,516

## Abstract

OVERALL SUMMARY/ABSTRACT
This is a revised competitive renewal application for a Program focused on high-risk neuroblastoma (NB), a
diverse and enigmatic malignancy arising from the developing sympathetic nervous system that remains lethal
in 50% of patients despite intensive multi-modal therapy. The primary goal of this multi-institutional and multi-
disciplinary Program is to achieve improved outcomes for patients with high-risk NB by 1) discovering basic
mechanisms of de novo and acquired resistance to modern therapies; 2) uncovering targetable vulnerabilities
driving resistance; and 3) translating these insights into evidence-based clinical trials. The Program has been
productive, with important basic, translational, and clinical research achievements over the past 5.5 years. The
basic structure of the Program remains the same, with four Projects focusing on interrelated fundamental
problems in the broad fields of epigenomics, tumor microenvironment, and immuno-oncology. The central
hypothesis is that high-risk NBs evolve to evade therapeutic interventions but that these resistance
mechanisms can be targeted therapeutically. The motivation for the proposed research is the urgent need to
improve survival of patients with high-risk NB, and to decrease treatment-related morbidities. The four proposed
Projects will each address the three Specific Aims of the overall Program: 1) discover mechanisms of NB
therapy resistance; 2) discover tumor-intrinsic and -extrinsic therapeutic vulnerabilities imparted by therapy
resistance; and 3) develop readily translatable therapeutic strategies to exploit de novo and acquired
resistance mechanisms and molecular vulnerabilities. The Projects will each be supported by two Cores: A)
Administrative core; B) Translational, statistical, and clinical trials core. Unique to the Program is the New
Approaches to NB Therapy (NANT) consortium integrated into Core B now in its 22nd year. A major goal of the
NANT is to prioritize new therapies from our Projects for Phase 1 and 2 clinical trials in the high-risk NB relapse
population, with the goal of moving these to Phase 3 testing in newly diagnosed patients. The Program is
responsible for the two targeted investigational agents currently being tested in an ongoing Children’s
Oncology Group Phase 3 trial. The NANT also provides a unique resource of therapy resistant tumors and
other biospecimens for Project investigators. Importantly, all Projects have clear milestones to deliver one or
more clinical trial to the NANT, with Project specific studies designed to provide the portfolio of nonclinical data
required for efficient translation to the refractory NB patient population. This highly integrated Program
proposes a variety of innovative experimental strategies to uncover basic mechanisms of oncogenesis and
therapy resistance, but is steadfastly translational, as the investigative team is constituted of physicians who
care for children with this disease. The significance...

## Key facts

- **NIH application ID:** 10768921
- **Project number:** 2P01CA217959-06A1
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** JOHN M MARIS
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $2,545,516
- **Award type:** 2
- **Project period:** 2017-09-18 → 2029-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10768921

## Citation

> US National Institutes of Health, RePORTER application 10768921, Discovering and Exploiting Mechanisms of Neuroblastoma Therapy Resistance (2P01CA217959-06A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10768921. Licensed CC0.

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