**Pediatric Precision Laboratory Advanced Neuroblastoma Therapy Study** This study focuses on children with high-risk neuroblastoma, a type of cancer that affects nerve tissues. The study aims to test a new treatment approach using molecularly guided therapy with standard treatments, followed by a trial of standard immunotherapy with or without a drug called DFMO, and then DFMO maintenance. - **Key Points:** - The study is for children under 21 years with high-risk neuroblastoma. - Participants will undergo evaluations and treatments over a period of time. - Eligible participants must not have received certain prior treatments and must meet health and safety criteria. **Eligibility:** Children with neuroblastoma confirmed by tests can join if they meet specific health requirements. These include adequate heart, liver, and kidney function, and certain criteria regarding their cancer's stage and biology. Participants must not be pregnant, and those of childbearing age must use effective birth control. Written consent from participants or guardians is necessary. **Exclusion Criteria:** Children with certain favorable biological features, those who are breastfeeding, or those on other investigational drugs are not eligible. Participants with conditions that could affect study participation or result interpretation are also excluded.