Thesis Nina Gelineau

Neuroblastoma is a rare childhood cancer that mainly affects very young children. About half of all patients have high-risk disease, meaning the cancer has already spread when it is diagnosed. Although treatment is intensive and includes chemotherapy, surgery, radiotherapy, stem cell transplantation and immunotherapy, many children still experience relapse. One of the biggest challenges is that current diagnostic methods cannot detect tiny amounts of remaining cancer cells, known as minimal residual disease (MRD).
This thesis investigates how liquid biopsies can improve the care of children with high-risk neuroblastoma. Liquid biopsies analyze tumor material that is released into body fluids, such as blood or bone marrow, offering a minimally invasive way to monitor the disease.
The studies in this thesis show that liquid biopsies can detect residual disease more accurately than current standard methods, identify children with an extremely high risk of relapse, and provide valuable information about treatment response. Both RNA- and DNA-based techniques were explored. In addition, new personalized DNA tests were developed that can track tumor-specific genetic changes over time, allowing relapse to be detected earlier.
Together, these findings demonstrate that liquid biopsies have great potential to improve diagnosis, monitoring and personalized treatment for children with neuroblastoma. With further validation and international implementation, these techniques may help identify children who need more intensive treatment while sparing others from unnecessary toxicity. Ultimately, liquid biopsies could bring more precise, personalized care within reach for children with this aggressive disease.