Feasibility, toxicity and response of upfront metaiodobenzylguanidine therapy therapy followed by German Pediatric Oncology Group Neuroblastoma 2004 protocol in newly diagnosed stage 4 neuroblastoma patients

Kraal, K. C. J. M.; Bleeker, Gitta; Eck-Smit, Berthe L. F. van; Eijkelenburg, Natasha K. A. van; Berthold, Frank; Noesel, Max M. van; Caron, Huib N.; Tytgat, Godelieve A.M.

doi:10.1016/j.ejca.2016.12.013

Cited by 30 publications

(31 citation statements)

References 26 publications

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“…Historically, 131 I‐MIBG therapy has been used for the treatment of patients with relapsed or refractory disease . Recent studies have suggested that 131 I‐MIBG has a positive impact on outcomes when it is given at the time of diagnosis in conjunction with induction chemotherapy or with HDCT/ASCT . However, the optimal time to administer 131 I‐MIBG therapy has not been established.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility and effectiveness of treatment strategy of tandem high‐dose chemotherapy and autologous stem cell transplantation in combination with ¹³¹I‐MIBG therapy for high‐risk neuroblastoma

Suh

Koh

Min

et al. 2020

Pediatric Transplantation

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This study was performed to evaluate the safety and effectiveness of tandem HDCT/ASCT combined with targeted radiotherapy using 131I‐MIBG for high‐risk neuroblastoma. Patients with high‐risk neuroblastoma were treated with 8 to 10 cycles of induction chemotherapy before tandem HDCT/ASCT. Patients received 131I‐MIBG treatment before the second HDCT/ASCT. Local radiotherapy and maintenance therapy were performed after tandem HDCT/ASCT. Between 2012 and 2016, 19 patients were diagnosed with high‐risk neuroblastoma in our institution and 18 of them received tandem HDCT/ASCT combined with 131I‐MIBG therapy. For the first HDCT/ASCT regimen, 12 patients received busulfan/melphalan and six patients received melphalan/etoposide/carboplatin. The second HDCT included ThioCy. The median dose of 131I‐MIBG was 17.2 mCi/kg for the first eight patients, while 12 patients in the latter period of the study received reduced dose of 10.7 mCi/kg. The 5‐year OS and EFS rates were 79% and 61%, respectively, for all 19 patients with high‐risk neuroblastoma, and 83% and 64%, respectively, for 18 patients who completed tandem HDCT/ASCT combined with 131I‐MIBG therapy. Six patients experienced disease relapse and five patients died. Treatment‐related mortality was not observed. Among 15 evaluable patients, 11 patients (73%) developed hypothyroidism, six patients (40%) had CKD, and six patients (40%) had growth failure. Hypothyroidism and growth failure were less frequent in patients who received reduced doses of 131I‐MIBG therapy. Tandem HDCT/ASCT combined with HD 131I‐MIBG therapy could be feasible for patients with high‐risk neuroblastoma with acceptable toxicity profiles and favorable outcomes.

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Section: Discussionmentioning

confidence: 99%

“…[6][7][8] Recent studies have suggested that 131 I-MIBG has a positive impact on outcomes when it is given at the time of diagnosis in conjunction with induction chemotherapy or with HDCT/ASCT. [25][26][27] CKD, n (%) 4 (67) 2 (22) .136…”

Section: Discussionmentioning

confidence: 99%

Feasibility and effectiveness of treatment strategy of tandem high‐dose chemotherapy and autologous stem cell transplantation in combination with ¹³¹I‐MIBG therapy for high‐risk neuroblastoma

Suh

Koh

Min

et al. 2020

Pediatric Transplantation

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“…was administered as a fixed dose: first course 131 I-MIBG dose was 7.4 GBq (200 mCi) and second course 5.5 GBq (150 mCi; ref. 14).…”

Section: Translational Relevancementioning

confidence: 99%

“…As 131 I-MIBG-therapy-related hematologic side effects have been reported, we questioned if 131 I-MIBG, when given upfront, would affect hematopoietic stem and progenitor cells (e.g., CD34 þ cells) and/or the BM microenvironment, hence impairing the ability to harvest mobilized CD34 þ cells. In a pilot study, that mainly focused on upfront 131 I-MIBG-therapy toxicity and efficacy, we observed a CD34 þ cell harvest failure in only 2 of 21 patients (14). The primary aim of this study was to evaluate feasibility of stem cell apheresis after upfront 131 I-MIBG-therapy in a larger cohort of patients with HR-NBL, and determine the effect on hematologic reconstitution after ASCT.…”

Section: Introductionmentioning

confidence: 99%

Peripheral Stem Cell Apheresis is Feasible Post 131Iodine-Metaiodobenzylguanidine-Therapy in High-Risk Neuroblastoma, but Results in Delayed Platelet Reconstitution

Kraal

Timmerman

Kansen

et al. 2019

Clinical Cancer Research

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Purpose: Targeted radiotherapy with 131 iodine-metaiodobenzylguanidine ( 131 I-MIBG) is effective for neuroblastoma (NBL), although optimal scheduling during high-risk (HR) treatment is being investigated. We aimed to evaluate the feasibility of stem cell apheresis and study hematologic reconstitution after autologous stem cell transplantation (ASCT) in patients with HR-NBL treated with upfront 131 I-MIBG-therapy.Experimental Design: In two prospective multicenter cohort studies, newly diagnosed patients with HR-NBL were treated with two courses of 131 I-MIBG-therapy, followed by an HR-induction protocol. Hematopoietic stem and progenitor cell (e.g., CD34 þ cell) harvest yield, required number of apheresis sessions, and time to neutrophil (>0.5 Â 10 9 /L) and platelet (>20 Â 10 9 /L) reconstitution after ASCT were analyzed and compared with "chemotherapy-only"-treated patients. Moreover, harvested CD34 þ cells were functionally (viability and clonogenic capacity) and phenotypically (CD33, CD41, and CD62L) tested before cryopreservation (n ¼ 44) and/or after thawing (n ¼ 19).Results: Thirty-eight patients (47%) were treated with 131

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“…Up-front MIBG therapy appears to be safe and tolerable, again with myelosuppression being the major toxicity (89)(90)(91) (91). The causes of the relatively modest response to MIBG therapy are likely to be multifactorial (92) and have motivated consideration of strategies such as highdose or multiple-dose MIBG therapy to enhance response in refractory patients. Limitations related to radiation safety precautions and tolerability restrict the dose of MIBG that can be administered as a single dose.…”

Section: Net Targeting For Therapy 123 I/ 131 I-mibg Theranostics Formentioning

confidence: 99%

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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Feasibility, toxicity and response of upfront metaiodobenzylguanidine therapy therapy followed by German Pediatric Oncology Group Neuroblastoma 2004 protocol in newly diagnosed stage 4 neuroblastoma patients

Cited by 30 publications

References 26 publications

Feasibility and effectiveness of treatment strategy of tandem high‐dose chemotherapy and autologous stem cell transplantation in combination with ¹³¹I‐MIBG therapy for high‐risk neuroblastoma

Feasibility and effectiveness of treatment strategy of tandem high‐dose chemotherapy and autologous stem cell transplantation in combination with ¹³¹I‐MIBG therapy for high‐risk neuroblastoma

Peripheral Stem Cell Apheresis is Feasible Post 131Iodine-Metaiodobenzylguanidine-Therapy in High-Risk Neuroblastoma, but Results in Delayed Platelet Reconstitution

Norepinephrine Transporter as a Target for Imaging and Therapy

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Feasibility, toxicity and response of upfront metaiodobenzylguanidine therapy therapy followed by German Pediatric Oncology Group Neuroblastoma 2004 protocol in newly diagnosed stage 4 neuroblastoma patients

Cited by 30 publications

References 26 publications

Feasibility and effectiveness of treatment strategy of tandem high‐dose chemotherapy and autologous stem cell transplantation in combination with 131I‐MIBG therapy for high‐risk neuroblastoma

Feasibility and effectiveness of treatment strategy of tandem high‐dose chemotherapy and autologous stem cell transplantation in combination with 131I‐MIBG therapy for high‐risk neuroblastoma

Peripheral Stem Cell Apheresis is Feasible Post 131Iodine-Metaiodobenzylguanidine-Therapy in High-Risk Neuroblastoma, but Results in Delayed Platelet Reconstitution

Norepinephrine Transporter as a Target for Imaging and Therapy

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Feasibility and effectiveness of treatment strategy of tandem high‐dose chemotherapy and autologous stem cell transplantation in combination with ¹³¹I‐MIBG therapy for high‐risk neuroblastoma

Feasibility and effectiveness of treatment strategy of tandem high‐dose chemotherapy and autologous stem cell transplantation in combination with ¹³¹I‐MIBG therapy for high‐risk neuroblastoma