Limits...
Iodine-131 metaiodobenzylguanidine therapy for neuroblastoma: reports so far and future perspective.

Kayano D, Kinuya S - ScientificWorldJournal (2015)

Bottom Line: Since iodine-131 (I-131) MIBG therapy was firstly reported, many trails of MIBG therapy in patients with neuroblastoma were performed.Though monotherapy with a low dose of I-131 MIBG could achieve high-probability pain reduction, the objective response was poor.In addition, I-131 MIBG therapy incorporated in the induction therapy was proved to be feasible in patients with newly diagnosed neuroblastoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan.

ABSTRACT
Neuroblastoma, which derives from neural crest, is the most common extracranial solid cancer in childhood. The tumors express the norepinephrine (NE) transporters on their cell membrane and take in metaiodobenzylguanidine (MIBG) via a NE transporter. Since iodine-131 (I-131) MIBG therapy was firstly reported, many trails of MIBG therapy in patients with neuroblastoma were performed. Though monotherapy with a low dose of I-131 MIBG could achieve high-probability pain reduction, the objective response was poor. In contrast, more than 12 mCi/kg I-131 MIBG administrations with or without hematopoietic cell transplantation (HCT) obtain relatively good responses in patients with refractory or relapsed neuroblastoma. The combination therapy with I-131 MIBG and other modalities such as nonmyeloablative chemotherapy and myeloablative chemotherapy with HCT improved the therapeutic response in patients with refractory or relapsed neuroblastoma. In addition, I-131 MIBG therapy incorporated in the induction therapy was proved to be feasible in patients with newly diagnosed neuroblastoma. To expand more the use of MIBG therapy for neuroblastoma, further studies will be needed especially in the use at an earlier stage from diagnosis, in the use with other radionuclide formations of MIBG, and in combined use with other therapeutic agents.

No MeSH data available.


Related in: MedlinePlus

A 10-year-old male with relapsed neuroblastoma. He was treated with 16.8 mCi/kg I-131 MIBG. Multiple lymph nodes and bone metastases are detected by I-131 MIBG scintigraphy (arrows). After the treatment with chemotherapy and whole-body irradiation, he received CBSCT 4 weeks after the I-131 MIBG therapy. Complete remission has been maintained for more than 12 months.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4385691&req=5

fig2: A 10-year-old male with relapsed neuroblastoma. He was treated with 16.8 mCi/kg I-131 MIBG. Multiple lymph nodes and bone metastases are detected by I-131 MIBG scintigraphy (arrows). After the treatment with chemotherapy and whole-body irradiation, he received CBSCT 4 weeks after the I-131 MIBG therapy. Complete remission has been maintained for more than 12 months.

Mentions: Allogeneic HCT (allo-HCT) has been regarded as an alternative procedure for advanced neuroblastoma when autologous stem cells could not be obtained sufficiently [53, 54]. Some studies have recently reported the possibility to induce a graft-versus-tumor (GVT) effect against advanced neuroblastoma [55–57]. Two patients with relapsed neuroblastoma treated with I-131 MIBG and allo-HCT were reported in case reports from Japan [58, 59]. A 6-year-old female with relapsed neuroblastoma received reduced-intensity allo-HCT 21 days after I-131 MIBG therapy [59]. Though no GVT effect was observed, the patient was in CR for 3 months after allo-HCT. A 5-year-old female with relapsed neuroblastoma was executed cord blood stem cell transplantation (CBSCT) 9 days after I-131 MIBG therapy and GVT effect was observed after CBSCT [58]. Normalization of both vanillylmandelic acid and homovanillic acid for 5 months and decrease of I-123 MIBG accumulations were maintained, although the patient died 12 months after CBSCT. A 10-year-old male with relapsed neuroblastoma received I-131 MIBG therapy and CBSCT. Then, he got in remission for more than 12 months after the therapy (Figure 2). Though these reports indicate the potency of the combination therapy with I-131 MIBG and allo-HCT, prospective trials combining I-131 MIBG with allo-HCT will be required.


Iodine-131 metaiodobenzylguanidine therapy for neuroblastoma: reports so far and future perspective.

Kayano D, Kinuya S - ScientificWorldJournal (2015)

A 10-year-old male with relapsed neuroblastoma. He was treated with 16.8 mCi/kg I-131 MIBG. Multiple lymph nodes and bone metastases are detected by I-131 MIBG scintigraphy (arrows). After the treatment with chemotherapy and whole-body irradiation, he received CBSCT 4 weeks after the I-131 MIBG therapy. Complete remission has been maintained for more than 12 months.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4385691&req=5

fig2: A 10-year-old male with relapsed neuroblastoma. He was treated with 16.8 mCi/kg I-131 MIBG. Multiple lymph nodes and bone metastases are detected by I-131 MIBG scintigraphy (arrows). After the treatment with chemotherapy and whole-body irradiation, he received CBSCT 4 weeks after the I-131 MIBG therapy. Complete remission has been maintained for more than 12 months.
Mentions: Allogeneic HCT (allo-HCT) has been regarded as an alternative procedure for advanced neuroblastoma when autologous stem cells could not be obtained sufficiently [53, 54]. Some studies have recently reported the possibility to induce a graft-versus-tumor (GVT) effect against advanced neuroblastoma [55–57]. Two patients with relapsed neuroblastoma treated with I-131 MIBG and allo-HCT were reported in case reports from Japan [58, 59]. A 6-year-old female with relapsed neuroblastoma received reduced-intensity allo-HCT 21 days after I-131 MIBG therapy [59]. Though no GVT effect was observed, the patient was in CR for 3 months after allo-HCT. A 5-year-old female with relapsed neuroblastoma was executed cord blood stem cell transplantation (CBSCT) 9 days after I-131 MIBG therapy and GVT effect was observed after CBSCT [58]. Normalization of both vanillylmandelic acid and homovanillic acid for 5 months and decrease of I-123 MIBG accumulations were maintained, although the patient died 12 months after CBSCT. A 10-year-old male with relapsed neuroblastoma received I-131 MIBG therapy and CBSCT. Then, he got in remission for more than 12 months after the therapy (Figure 2). Though these reports indicate the potency of the combination therapy with I-131 MIBG and allo-HCT, prospective trials combining I-131 MIBG with allo-HCT will be required.

Bottom Line: Since iodine-131 (I-131) MIBG therapy was firstly reported, many trails of MIBG therapy in patients with neuroblastoma were performed.Though monotherapy with a low dose of I-131 MIBG could achieve high-probability pain reduction, the objective response was poor.In addition, I-131 MIBG therapy incorporated in the induction therapy was proved to be feasible in patients with newly diagnosed neuroblastoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan.

ABSTRACT
Neuroblastoma, which derives from neural crest, is the most common extracranial solid cancer in childhood. The tumors express the norepinephrine (NE) transporters on their cell membrane and take in metaiodobenzylguanidine (MIBG) via a NE transporter. Since iodine-131 (I-131) MIBG therapy was firstly reported, many trails of MIBG therapy in patients with neuroblastoma were performed. Though monotherapy with a low dose of I-131 MIBG could achieve high-probability pain reduction, the objective response was poor. In contrast, more than 12 mCi/kg I-131 MIBG administrations with or without hematopoietic cell transplantation (HCT) obtain relatively good responses in patients with refractory or relapsed neuroblastoma. The combination therapy with I-131 MIBG and other modalities such as nonmyeloablative chemotherapy and myeloablative chemotherapy with HCT improved the therapeutic response in patients with refractory or relapsed neuroblastoma. In addition, I-131 MIBG therapy incorporated in the induction therapy was proved to be feasible in patients with newly diagnosed neuroblastoma. To expand more the use of MIBG therapy for neuroblastoma, further studies will be needed especially in the use at an earlier stage from diagnosis, in the use with other radionuclide formations of MIBG, and in combined use with other therapeutic agents.

No MeSH data available.


Related in: MedlinePlus