Neuroblastoma (NB) is the most common extra cranial solid tumor of childhood, 
with 60% of patients presenting with high risk (HR) NB by means of clinical, 
pathological and biological features. The 5-year survival rate for HR-NB remains 
below 40%, with the majority of patients suffering relapse from chemorefractory 
tumor. Immunotherapy is the main strategy against minimal residual disease and 
clinical experience has mostly focused on monoclonal antibodies (MoAb) against 
the glycolipid disialoganglioside GD2. Three anti-GD2 antibodies have been 
tested in the clinic including murine 14G2a, human-mouse chimeric ch14.18 and 
3F8. Anti-GD2 MoAb induces cellular cytoxicity against NB and is most effective 
when effector cells like natural killer cells, granulocytes and macrophages are 
amplified by cytokines. The combination of cytokines IL-2 and GM-CSF with the 
anti-GD2 MoAb ch14.18 (Dinutuximab) has shown a significant improvement in 
outcome for HR-NB. The FDA and EMA approved dinutuximab (Unituxin(R)) in 2015 
for the treatment of patients with HR-NB who achieved at least a partial 
response after multimodality therapy.