Outcomes for Patients Aged 12–18 Months With Metastatic <i>MYCN</i> Non‐Amplified Neuroblastoma and Unfavorable Biologic Features (“Mixed Biology Toddlers”): A Report From the International Neuroblastoma Risk Group (INRG) Project
Bibliographic record
Abstract
BACKGROUND: Toddlers (age 365-<547 days) with MYCN non-amplified (MYCN-NA) metastatic neuroblastoma (NBL) that have at least one unfavorable biologic feature ("mixed biology toddlers") are a rare NBL subgroup in need of further study. METHODS: Using the International Neuroblastoma Risk Group (INRG) Data Commons, we identified all toddlers with newly diagnosed metastatic, MYCN-NA NBL. Unfavorable biologic features included (1) unfavorable histology, (2) DNA index ≤1, (3) 1p loss of heterozygosity (LOH), and (4) 11q LOH. Kaplan-Meier curves of event-free survival (EFS) and overall survival (OS) were generated and compared using a log rank test; Cox proportional hazard regression models were used for multivariable analysis. RESULTS: Of the 450 patients identified, 157 had ≥1 unfavorable biologic feature and 26 had all favorable features. After adjusting for unfavorable biologic features, only high ferritin and high lactate dehydrogenase (LDH) remained significantly associated with worse EFS and OS. A total of 5-year EFS for mixed biology toddlers was 74.3% versus 88.5% for those with all favorable biologic features; 5-year OS was 79.3% versus 100%, respectively. CONCLUSION: Mixed biology toddlers have lower EFS and OS compared to those whose tumors have favorable biologic features. Inclusion in high-risk NBL trials should be considered for this rare subgroup.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".