PURPOSE: Treatment of refractory neuroblastoma remains a significant clinical problem. Targeted radiotherapy with 131I-MIBG has demonstrated antitumor activity in heavily pretreated neuroblastoma patients with recurrent disease. Response rates may be correlated with total radionuclide dose per kilogram body weight delivered, but higher dose levels are associated with protracted grade 4 hematologic toxicity. The optimal method for using single-agent 131I-MIBG for patients with relapsed high-risk neuroblastoma has not been defined. This study was designed to retrospectively determine the clinical response to 131I-MIBG therapy at submyeloablative doses in patients with refractory neuroblastoma and to describe the toxicities. PATIENTS AND METHODS: A retrospective chart review of 20 patients with neuroblastoma treated with 131I-MIBG at the Children's Hospital of Philadelphia from 1988 to 2000 was performed. Demographic data, 131I-MIBG dose delivered, toxicities, and clinical responses were reviewed. RESULTS: A median dose of 9.5 mCi/kg of 131I-MIBG was delivered in 32 courses to 20 patients. Three patients were treated in first complete response, and the remaining 17 patients for residual and/or progressive disease. The objective response rate to the first therapy was 31%, and the remaining patients achieved disease stabilization. In addition, 9 of 11 patients with pain at study entry had significant improvement. Disease response was not correlated with 131I-MIBG dose delivered. No unanticipated toxicities were observed. CONCLUSIONS: Submyeloablative-dose 131I-MIBG is an effective and relatively nontoxic method for neuroblastoma disease palliation. Most patients show subjective improvement in pain and/or performance status. Increased availability and experience with 131I-MIBG therapy would benefit a large number of children with end-stage neuroblastoma and no realistic hope for cure.
PURPOSE: Treatment of refractory neuroblastoma remains a significant clinical problem. Targeted radiotherapy with 131I-MIBG has demonstrated antitumor activity in heavily pretreated neuroblastomapatients with recurrent disease. Response rates may be correlated with total radionuclide dose per kilogram body weight delivered, but higher dose levels are associated with protracted grade 4 hematologic toxicity. The optimal method for using single-agent 131I-MIBG for patients with relapsed high-risk neuroblastoma has not been defined. This study was designed to retrospectively determine the clinical response to 131I-MIBG therapy at submyeloablative doses in patients with refractory neuroblastoma and to describe the toxicities. PATIENTS AND METHODS: A retrospective chart review of 20 patients with neuroblastoma treated with 131I-MIBG at the Children's Hospital of Philadelphia from 1988 to 2000 was performed. Demographic data, 131I-MIBG dose delivered, toxicities, and clinical responses were reviewed. RESULTS: A median dose of 9.5 mCi/kg of 131I-MIBG was delivered in 32 courses to 20 patients. Three patients were treated in first complete response, and the remaining 17 patients for residual and/or progressive disease. The objective response rate to the first therapy was 31%, and the remaining patients achieved disease stabilization. In addition, 9 of 11 patients with pain at study entry had significant improvement. Disease response was not correlated with 131I-MIBG dose delivered. No unanticipated toxicities were observed. CONCLUSIONS: Submyeloablative-dose 131I-MIBG is an effective and relatively nontoxic method for neuroblastoma disease palliation. Most patients show subjective improvement in pain and/or performance status. Increased availability and experience with 131I-MIBG therapy would benefit a large number of children with end-stage neuroblastoma and no realistic hope for cure.
Authors: Vandana Batra; Minu Samanta; Mehran Makvandi; David Groff; Paul Martorano; Jimmy Elias; Pietro Ranieri; Matthew Tsang; Catherine Hou; Yimei Li; Bruce Pawel; Daniel Martinez; Ganesan Vaidyanathan; Sean Carlin; Daniel A Pryma; John M Maris Journal: Clin Cancer Res Date: 2022-09-15 Impact factor: 13.801
Authors: Katherine K Matthay; Alekist Quach; John Huberty; Benjamin L Franc; Randall A Hawkins; Hollie Jackson; Susan Groshen; Suzanne Shusterman; Gregory Yanik; Janet Veatch; Patricia Brophy; Judith G Villablanca; John M Maris Journal: J Clin Oncol Date: 2009-01-26 Impact factor: 44.544
Authors: Shakeel Modak; Pat Zanzonico; Jorge A Carrasquillo; Brian H Kushner; Kim Kramer; Nai-Kong V Cheung; Steven M Larson; Neeta Pandit-Taskar Journal: J Nucl Med Date: 2016-01-07 Impact factor: 10.057