The study is led by one of our Advisory Board Members, Dr. Giselle Sholler. Dr. Sholler has previously found that it is possible to sequence and analyze pediatric tumors in real time for patient treatment and that by understanding the genomic changes and pathways driving cancers to grow that we can then identify drugs specifically designed for patients. This is the future of cancer treatment. Over the past year, it has been shown that it is possible and safe to use genomic information at diagnosis. This current study expands on this to test if we can improve overall survival in high risk neuroblastoma by using precision medicine at diagnosis. This study is a prospective, multi-center study evaluating the use of molecular guided therapy in combination with standard therapy followed by maintenance therapy with DFMO in subjects with newly diagnosed high-risk neuroblastoma to improve overall survival for children with high risk neuroblastoma.