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  • Daniel Morgenstern,
  • Karsten Nysom,
  • Andrea Gomez Morad,
  • Margarida Simão Rafael,
  • Judith Zier,
  • Araz Marachelian,
  • Tanya Watt
Daniel Morgenstern
The Hospital for Sick Children

Corresponding Author:[email protected]

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Karsten Nysom
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Andrea Gomez Morad
Boston Children's Hospital
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Margarida Simão Rafael
The Hospital for Sick Children
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Judith Zier
Children's Respiratory and Critical Care Specialists PA
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Araz Marachelian
Children's Hospital Los Angeles Department of Hematology and Oncology
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Tanya Watt
The University of Texas Southwestern Medical Center
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Monoclonal antibodies (mAbs) targeting disialoganglioside 2 (GD2) are an important treatment advance for high-risk neuroblastoma, including in patients with refractory or relapsed disease. Dinutuximab and dinutuximab beta are administered for ≥8 hours (and up to 10 days for dinutuximab beta), whereas naxitamab is administered over 0.5 to 2 hours as tolerated. As acute pain is a class effect of anti-GD2 mAbs, effective pain management is crucial to successful treatment. Here, we provide an overview of current pain-management strategies for anti-GD2 mAb infusions, including discussion of opioid analgesics, ketamine, gabapentin, and other similar agents, and non-pharmacologic approaches. Potential future pain management options are also discussed, in addition to the use of sedatives to reduce the anxiety that may be associated with infusion-related pain. Specific guidance for pain management during naxitamab infusions is provided, as these infusions are administered over 0.5 to 2 hours and may not need overnight hospitalization based on the physician’s assessment, and require rapid-onset analgesia options suitable for potential outpatient administration.
20 Oct 2022Submitted to Pediatric Blood & Cancer
20 Oct 2022Submission Checks Completed
20 Oct 2022Assigned to Editor
20 Oct 2022Review(s) Completed, Editorial Evaluation Pending
20 Oct 2022Reviewer(s) Assigned
05 Nov 2022Editorial Decision: Revise Minor
20 Dec 20221st Revision Received
20 Dec 2022Submission Checks Completed
20 Dec 2022Assigned to Editor
20 Dec 2022Review(s) Completed, Editorial Evaluation Pending
21 Dec 2022Reviewer(s) Assigned
03 Jan 2023Editorial Decision: Accept