A systematic review of 131I-meta iodobenzylguanidine molecular radiotherapy for neuroblastoma

Wilson, Jayne S.; Gains, J.; Moroz, Veronica; Wheatley, Keith; Gaze, Mark

doi:10.1016/j.ejca.2013.11.016

Cited by 131 publications

(109 citation statements)

References 37 publications

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“…The response rate was lower than reported with single-agent MIBG (8–9) or in our previous dose escalation study of MIBG together with vincristine/irinotecan (11). We note that response rates (both overall and by MIBG scan) were more encouraging at the recommended dose level 5a of this regimen.…”

Section: Discussioncontrasting

confidence: 70%

“…Approximately 90% of neuroblastoma tumors accumulate MIBG via the norepinephrine transporter (NET), making MIBG a targeted option for the majority of patients (5–6). MIBG at its usual maximum feasible dose of 18 mCi/kg has been shown to be among the most active agents for children with relapsed or refractory neuroblastoma (7–9). Non-hematologic toxicity is generally mild and hematologic toxicity can be abrogated with autologous stem cell support (10).…”

Section: Introductionmentioning

confidence: 99%

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Phase I Study of Vorinostat as a Radiation Sensitizer with 131I-Metaiodobenzylguanidine (131I-MIBG) for Patients with Relapsed or Refractory Neuroblastoma

DuBois

Groshen

Park

et al. 2015

Clinical Cancer Research

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Purpose 131I-metaiodobenzylguanidine (MIBG) is a radiopharmaceutical with activity in neuroblastoma. Vorinostat is a histone deacetylase inhibitor that has radiosensitizing properties. The goal of this phase 1 study was to determine the maximum tolerated doses of vorinostat and MIBG in combination. Experimental Design Patients ≤ 30 years with relapsed/refractory MIBG-avid neuroblastoma were eligible. Patients received oral vorinostat (dose levels 180 and 230 mg/m2) daily Days 1–14. MIBG (dose levels 8, 12, 15, and 18 mCi/kg) was given on Day 3 and peripheral blood stem cells on Day 17. Alternating dose escalation of vorinostat and MIBG was performed using a 3+3 design. Results 27 patients enrolled to 6 dose levels, with 23 evaluable for dose escalation. No dose-limiting toxicities (DLT) were seen in the first three dose levels. At dose level 4 (15 mCi/kg MIBG/230 mg/m2 vorinostat), 1 of 6 patients had DLT with grade 4 hypokalemia. At dose level 5 (18 mCi/kg MIBG/230 mg/m2 vorinostat), two patients had dose-limiting bleeding (one grade 3 and one grade 5). At dose level 5a (18 mCi/kg MIBG/180 mg/m2 vorinostat), 0 of 6 patients had DLT. The most common toxicities were neutropenia and thrombocytopenia. The response rate was 12% across all dose levels and 17% at dose level 5a. Histone acetylation increased from baseline in peripheral blood mononuclear cells collected on Days 3 and 12–14. Conclusions Vorinostat at 180 mg/m2/dose is tolerable with 18 mCi/kg MIBG. A phase 2 trial comparing this regimen to single-agent MIBG is ongoing.

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Section: Discussioncontrasting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Phase I Study of Vorinostat as a Radiation Sensitizer with 131I-Metaiodobenzylguanidine (131I-MIBG) for Patients with Relapsed or Refractory Neuroblastoma

DuBois

Groshen

Park

et al. 2015

Clinical Cancer Research

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“…The two radiopharmaceuticals currently used in pediatric cancer therapy include 131-iodine to treat differentiated thyroid cancer and 131 I-MIBG to treat neuroblastoma [62]. As a consequence of primary surgical therapy for thyroid cancer, children treated with 131 I already have established postoperative hypothyroidism.…”

Section: Radiation-induced Thyroid Diseasementioning

confidence: 99%

Thyroid Sequelae of Pediatric Cancer Therapy

Waguespack

2018

Horm Res Paediatr

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The hypothalamic-pituitary-thyroid axis is a common site of unintended, acquired disease either during or after the treatment of cancer. Children treated with external radiation therapy are at the highest risk for developing a thyroid-related late effect, but thyroid dysfunction and second primary thyroid neoplasms can also occur after treatment with radiopharmaceutical agents such as ¹³¹I-metaiodobenzylguanidine. Increasingly recognized is the development of early thyroid dysfunction as an off-target consequence of the more novel cancer therapeutics such as the tyrosine kinase inhibitors and immune checkpoint inhibitors. Thyroid sequelae resulting from irradiation may manifest only after years to decades of follow-up, and their resultant clinical symptoms may be indolent and non-specific. Therefore, lifelong monitoring of the childhood cancer survivor at risk for thyroid disease is paramount. In this comprehensive review, the myriad thyroid adverse effects resulting from pediatric cancer treatment are discussed and an overview of screening and treatment of these thyroid sequelae provided.

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“…Since mIBG has a similar transport mechanism to norepinephrine, 90% percent of neuroblastoma is mIBG avid [4,5]. [ 131 I]MIBG TRT has become a standard treatment approach for recurrent or refractory cases of neuroblastoma with response rates of 20% – 37% [2,3,6–8]. …”

Section: Introductionmentioning

confidence: 99%

Patient-Specific Dosimetry Using Pretherapy [124I]m-iodobenzylguanidine ([124I]mIBG) Dynamic PET/CT Imaging Before [131I]mIBG Targeted Radionuclide Therapy for Neuroblastoma

et al. 2014

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Purpose Iodine-131-m-iodobenzylguanidine ([131I]mIBG) targeted radionuclide therapy (TRT) is a standard treatment for recurrent or refractory neuroblastoma with response rates of 30–40%. The aim of this study is to demonstrate patient-specific dosimetry using quantitative [124I]mIBG PET/CT imaging with a Geant4-based Monte Carlo method for better treatment planning. Procedures A Monte Carlo dosimetry method was developed using the Geant4 toolkit with voxelized anatomical geometry and source distribution as input. The pre-segmented hybrid computational human phantoms developed by the University of Florida and the National Cancer Institute (UF/NCI) were used as a surrogate to characterize the anatomy of a given patient. S-values for I-131 were estimated by the phantoms coupled with Geant4 and compared with those estimated by OLINDA|EXM and MCNPX for the newborn model. To obtain patient-specific biodistribution of [131I]mIBG, a 10-year-old girl with relapsed neuroblastoma was imaged with [124I]mIBG PET/CT at four time points prior to the planned [131I]mIBG TRT. The organ and tumor absorbed dose of the clinical case were estimated with the Geant4 method using the modified UF/NCI 10-year-old phantom with tumors and the patient-specific residence time. Results For the newborn model, the Geant4 S-values were consistent with the MCNPX S- values. The S-value ratio of the Geant4 method to OLINDA|EXM ranged from 0.08 to 6.5 of all major organs. The [131I]mIBG residence time quantified from the pretherapy [124I]mIBG PET/CT imaging of the 10-year-old patient was mostly comparable to those previously reported. Organ absorbed dose for the salivary glands were 98.0 Gy, heart wall, 36.5 Gy, and liver, 34.3 Gy; while tumor absorbed dose ranged from 143.9 Gy to 1641.3 Gy in different sites. Conclusions Patient-specific dosimetry for [131I]mIBG targeted radionuclide therapy was accomplished using pretherapy [124I]mIBG PET/CT imaging and a Geant4-based Monte Carlo dosimetry method. The Geant4 method with quantitative pretherapy imaging can provide dose estimates to normal organs and tumors with more realistic simulation geometry, and thus may improve treatment planning for [131I]mIBG TRT.

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A systematic review of 131I-meta iodobenzylguanidine molecular radiotherapy for neuroblastoma

Cited by 131 publications

References 37 publications

Phase I Study of Vorinostat as a Radiation Sensitizer with 131I-Metaiodobenzylguanidine (131I-MIBG) for Patients with Relapsed or Refractory Neuroblastoma

Phase I Study of Vorinostat as a Radiation Sensitizer with 131I-Metaiodobenzylguanidine (131I-MIBG) for Patients with Relapsed or Refractory Neuroblastoma

Thyroid Sequelae of Pediatric Cancer Therapy

Patient-Specific Dosimetry Using Pretherapy [124I]m-iodobenzylguanidine ([124I]mIBG) Dynamic PET/CT Imaging Before [131I]mIBG Targeted Radionuclide Therapy for Neuroblastoma

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