About the Project

High-risk neuroblastoma accounts for 15% of cancer-related deaths in children. Half of the patients diagnosed with neuroblastoma in the EU have high-risk disease and recurrences occur frequently. In these children, conventional therapies are no longer effective. Monitoring for disease relapse and therapy response is crucial for the survival chance of these patients. The current standard of care for monitoring relies on imaging technologies and bone marrow assessment, which are costly, invasive and a burden for children and their families. More sensitive, less invasive and less toxic monitoring techniques are needed in neuroblastoma. Liquid biopsy is a suitable alternative technique because it is minimally invasive, allows frequent sampling and can sensitively detect tumour molecular markers in the blood. 

Under the coordination of SIOPE and the scientific lead of St. Anna Children's Cancer Research Institute and Princess Máxima Center for Paediatric Oncology, MONALISA is conducting a pragmatic clinical trial to evaluate the use of liquid biopsies as a monitoring tool for relapsed neuroblastoma. We will test if liquid biopsies can detect relapse events earlier than the standard of care and consequently avoid unnecessary diagnostic procedures. This approach will also help to personalise treatment options and may prevent both over- and under-treatment. Ultimately, the goal is to improve the quality of life of affected children by enabling earlier accurate tumour detection and hopefully better overall survival through more targeted treatment interventions.

MONALISA will set the basis to establish liquid biopsies as standard-of-care to monitor relapsed neuroblastoma, as a blueprint for other paediatric cancers. 


Project Objectives

  • Monitor patients with relapsed neuroblastoma​
  • Reliable assessment of early molecular progression or relapse​
  • Establish a pragmatic randomized clinical trial​
  • Develop a digital decision support tool to help oncologists use the new monitoring
  • Assess patient-reported outcomes and quality of life


Expected Outcomes and Impact

  • Reduced time to relapse detection
  • Improved overall survival of patients with neuroblastoma
  • Change in care strategy
  • Improve quality of life
  • Increased acceptance among oncologists, patients and parents​
  • Accelerate digital transformation of research innovation ​
  • Knowledge dissemination​
  • Reduced healthcare costs​