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Immunotherapy with anti-disialoganglioside dinutuximab has improved survival for children with high-risk neuroblastoma (N when given after induction chemotherapy and surgery. However, disease recurrence and resistance persist. Dinutuximab efficacy has not been evaluated when initiated before primary tumor removal. Using a surgical mouse model of human NB, we examined if initiating dinutuximab plus ex vivo-activated natural killer (aNK) cells before resection of the primary tumor improves survival. In vitro, human NB cells (SMS-KCNR-Fluc