Effects and safety of 131I-metaiodobenzylguanidine (MIBG) radiotherapy in malignant neuroendocrine tumors: Results from a multicenter observational registry

Yoshinaga, Keiichiro; Oriuchi, Noboru; Wakabayashi, Hiroshi; Tomiyama, Yoshiaki; Jinguji, Megumi; Higuchi, Tetsuya; Kayano, Daiki; Fukuoka, Masayoshi; Inaki, Anri; Toratani, Ayane; Okamoto, Susumu; Shiga, Tohru; Ito, Yoichi M.; Nakajo, Masatoyo; Nakajo, Masayuki; Kinuya, Seigo

doi:10.1507/endocrj.ej14-0211

Cited by 46 publications

(41 citation statements)

References 31 publications

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“…A higher contrast was noted for uptake in the heart and slightly larger activity noted in the gastrointestinal tract compared with conventional 123 I-MIBG (123). At present, limited data exist regarding efficacy, and distinct clinical advantage of high-specific-activity MIBG has not been proven, though a lower incidence of side effects, such as nausea, vomiting, and hypertension, has been reported for both neuroblastoma and PHEO/PGL patients for imaging and therapy (109,124). (82,85,95,125).…”

Section: Strategies For Improving Net Targeting and Dose Delivery Witmentioning

confidence: 96%

“…The published literature is also heterogeneous in patient selection and the reported follow-up data, which may explain differences in observed response rates and survival. The reported overall complete response rates are low, ranging from 0% to 18% (106)(107)(108)(109)(110).…”

Section: I/ 131 I-mibg Theranostics For Pheo and Pglmentioning

confidence: 99%

“…Individual doses of 131 I-MIBG used for therapy in published studies are highly variable, ranging from low (2, (107)(108)(109)111). Most common treatment schemas used are multiple, low doses of MIBG therapy typically administered every 3-6 mo, primarily with a palliative rather than curative intent.…”

Section: I/ 131 I-mibg Theranostics For Pheo and Pglmentioning

confidence: 99%

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Norepinephrine Transporter as a Target for Imaging and Therapy

Pandit‐Taskar

Modak

2017

J Nucl Med

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The norepinephrine transporter (NET) is essential for norepinephrine uptake at the synaptic terminals and adrenal chromaffin cells. In neuroendocrine tumors, NET can be targeted for imaging as well as therapy. One of the most widely used theranostic agents targeting NET is metaiodobenzylguanidine (MIBG), a guanethidine analog of norepinephrine. 123 I/ 131 I-MIBG theranostics have been applied in the clinical evaluation and management of neuroendocrine tumors, especially in neuroblastoma, paraganglioma, and pheochromocytoma. 123 I-MIBG imaging is a mainstay in the evaluation of neuroblastoma, and 131 I-MIBG has been used for the treatment of relapsed high-risk neuroblastoma for several years, however, the outcome remains suboptimal. 131 I-MIBG has essentially been only palliative in paraganglioma/pheochromocytoma patients. Various techniques of improving therapeutic outcomes, such as dosimetric estimations, high-dose therapies, multiple fractionated administration and combination therapy with radiation sensitizers, chemotherapy, and other radionuclide therapies, are being evaluated. PET tracers targeting NET appear promising and may be more convenient options for the imaging and assessment after treatment. Here, we present an overview of NET as a target for theranostics; review its current role in some neuroendocrine tumors, such as neuroblastoma, paraganglioma/ pheochromocytoma, and carcinoids; and discuss approaches to improving targeting and theranostic outcomes.

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Section: Strategies For Improving Net Targeting and Dose Delivery Witmentioning

confidence: 96%

Section: I/ 131 I-mibg Theranostics For Pheo and Pglmentioning

confidence: 99%

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Norepinephrine Transporter as a Target for Imaging and Therapy

Pandit‐Taskar

Modak

2017

J Nucl Med

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“…A recent meta-analysis of the efficacy of 131 I-MIBG-therapy in malignant PCs/PGs showed that disease control and partial hormonal responses were obtained in 50 and 40% of patients, respectively . In a multicentre registry, partial response or stability of the disease according to the RECIST criteria was achieved in 85% of patients, with minor side effects in approximately 90% of patients (Yoshinaga et al 2014). However, there may also be long-term sequelae such as myelodysplastic disorders and haematological malignancies (Sze et al 2013).…”

Section: :6mentioning

confidence: 99%

Molecular targeted therapies in adrenal, pituitary and parathyroid malignancies

Angelousi¹,

Dimitriadis²,

Zografos³

et al. 2017

Endocrine-Related Cancer

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Tumourigenesis is a relatively common event in endocrine tissues. Currently, specific guidelines have been developed for common malignant endocrine tumours, which also incorporate advances in molecular targeted therapies (MTT), as in thyroid cancer and in gastrointestinal neuroendocrine malignancies. However, there is little information regarding the role and efficacy of MTT in the relatively rare malignant endocrine tumours mainly involving the adrenal medulla, adrenal cortex, pituitary, and parathyroid glands. Due to the rarity of these tumours and the lack of prospective studies, current guidelines are mostly based on retrospective data derived from surgical, locoregional and ablative therapies, and studies with systemic chemotherapy. In addition, in many of these malignancies the prognosis remains poor with individual patients responding differently to currently available treatments, necessitating the development of new personalised therapeutic strategies. Recently, major advances in the molecular understanding of endocrine tumours based on genomic, epigenomic, and transcriptome analysis have emerged, resulting in new insights into their pathogenesis and molecular pathology. This in turn has led to the use of novel MTTs in increasing numbers of patients. In this review, we aim to present currently existing and evolving data using MTT in the treatment of adrenal, pituitary and malignant parathyroid tumours, and explore the current utility and effectiveness of such therapies and their future evolution.

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“…131 I-MIBG is well tolerated and associates with disease stabilization or partial responses in more than 50% of cases and improvement of blood pressure indices, symptoms, and performance status in the majority of patients. PR or SD was achieved in more than 80% (Yoshinaga et al 2014). Dosimetric approaches need to be developed in order to improve treatment planning in a given patient (Sudbrock et al 2010, Sanchez-Crespo 2013.…”

Section: Radionuclide Therapymentioning

confidence: 99%

15 YEARS OF PARAGANGLIOMA: Imaging and imaging-based treatment of pheochromocytoma and paraganglioma

Castinetti¹,

Kroiss²,

Kumar³

et al. 2015

Endocrine-Related Cancer

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Although anatomic imaging to assess the precise localization of pheochromocytomas/ paragangliomas (PHEOs/PGLs) is unavoidable before any surgical intervention on these tumors, functional imaging is becoming an inseparable portion of the imaging algorithm for these tumors. This review article presents applications of the most up-to-date functional imaging modalities and image-based treatment to PHEOs/PGLs patients. Functional imaging techniques provide whole-body localization (number of tumors present along with metastatic deposits) together with genetic-specific imaging approaches to PHEOs/PGLs, thus enabling highly specific and sensitive PHEO/PGL detection and delineation that now greatly impact the management of patients. Radionuclide imaging techniques also play a crucial role in the prediction of possible radioactive treatment options for PHEO/PGL. In contrast to previous imaging algorithms used for either assessement of these patients or their follow-up, endocrinologists, surgeons, oncologists, pediatricians, and other specialists require functional imaging before any therapeutic plan is outlined to the patient, and follow-up, especially in patients with metastatic disease, is based on the periodic use of functional imaging, often reducing or substituting for anatomical imaging. In similar specific indications, this will be further powered by using PET/MR in the assessment of these tumors. In the near future, it is expected that PHEO/PGL patients will benefit even more from an assessement of the functional characteristics of these tumors and new imaging-based treatment options. Finally, due to the use of new targeting moieties, gene-targeted radiotherapeutics and nanobodiesbased theranostic approaches are expected to become a reality in the near future.

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Effects and safety of 131I-metaiodobenzylguanidine (MIBG) radiotherapy in malignant neuroendocrine tumors: Results from a multicenter observational registry

Cited by 46 publications

References 31 publications

Norepinephrine Transporter as a Target for Imaging and Therapy

Norepinephrine Transporter as a Target for Imaging and Therapy

Molecular targeted therapies in adrenal, pituitary and parathyroid malignancies

15 YEARS OF PARAGANGLIOMA: Imaging and imaging-based treatment of pheochromocytoma and paraganglioma

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