Different outcomes for relapsed versus refractory neuroblastoma after therapy with 131I-metaiodobenzylguanidine (131I-MIBG)

Zhou, Margaret; Doral, Michelle Y.; DuBois, Steven G.; Villablanca, Judith G.; Yanik, Gregory A.; Matthay, Katherine K.

doi:10.1016/j.ejca.2015.07.023

Cited by 52 publications

(43 citation statements)

References 25 publications

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“…The high metastatic failure rate in refractory and recurrent NB has led investigators to evaluate novel combinations of systemic therapy in the salvage setting . Some data suggest that patients with refractory disease might have better response rates with 131 I‐MIBG therapy than do patients with relapsing disease . 131 I‐MIBG therapy has currently moved to the forefront of initial therapy in treatment naïve patients in the COG ANBL1531 trial.…”

Section: Discussionmentioning

confidence: 94%

Managing local‐regional failure in children with high‐risk neuroblastoma: A single institution experience

Dove

Manole

Wakefield

et al. 2018

Pediatric Blood & Cancer

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Background: Intensification of systemic therapy for high-risk neuroblastoma (HRNB) has resulted in improved local control and overall survival leaving potential for de-escalation of primary site radiotherapy. The utility of primary site de-escalation should be evaluated in the context of potential for successful local-regional salvage. We evaluated salvage strategies and outcomes in HRNB patients with local-regional recurrence as a component of first failure. Methods: Twenty of 89 patients with HRNB experienced local-regional recurrence as a component of first relapse after chemotherapy, radiotherapy, surgery, and stem cell transplant from 1997–2013. We reviewed salvage therapy strategies and disease control, and report on the impact of local therapy as salvage for local-regional relapse. Results: Six of 20 patients with local-regional failure (LRF) were alive after a median follow-up of 13 years (range, 0.9–25.2 years). Median overall survival (OS) was 4.6 years (95% CI, 0.6 – not reached) vs. 0.6 years (95% CI, 0.05–2.6) after LRF with and without distant failure (DF) respectively (p=0.03). Overall survival in patients receiving salvage radiotherapy was comparable to those receiving initial adjuvant but no salvage radiotherapy. Time to first failure and death was significantly impacted by the intensity of frontline systemic therapy (p=0.03). Salvage radiotherapy reduced the hazard for subsequent LRF (HR 0.3, 95% CI 0.1–0.9, p=0.04) but not OS (p=0.07). Conclusions: Our study highlights the potential of local control strategies at first failure in patients with LRF when primary site radiotherapy was initially omitted, and delineates potential selection factors which may further improve the therapeutic ratio.

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Section: Discussionmentioning

confidence: 94%

Managing local‐regional failure in children with high‐risk neuroblastoma: A single institution experience

Dove

Manole

Wakefield

et al. 2018

Pediatric Blood & Cancer

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“…The effect of MIBG therapy on long-term survival in this group of patients remains unclear because most received further therapy after MIBG therapy (80,87). In addition, patients with relapsed disease appeared to have shorter progression-free survival after MIBG therapy than those with primary refractory neuroblastoma (88).…”

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

confidence: 98%

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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“…73 The response rate to 131 I-MIBG therapy in patients with refractory or relapsed neuroblastoma is 27%, with refractory patients demonstrating higher 24-month overall survival than relapsed patients. 74 …”

Section: Targeted Therapy For Neuroblastoma: a Developmental Neurobiomentioning

confidence: 99%

The “neuro” of neuroblastoma: Neuroblastoma as a neurodevelopmental disorder

Ratner

Brodeur

Dale

et al. 2016

Annals of Neurology

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Neuroblastoma is a childhood cancer derived from cells of neural crest origin. The hallmarks of its enigmatic character include its propensity for spontaneous regression under some circumstances and its association with paraneoplastic opsoclonus, myoclonus, and ataxia. The neurodevelopmental underpinnings of its origins may provide important clues for development of novel therapeutic and preventive agents for this frequently fatal malignancy and for the associated paraneoplastic syndromes.

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Different outcomes for relapsed versus refractory neuroblastoma after therapy with 131I-metaiodobenzylguanidine (131I-MIBG)

Cited by 52 publications

References 25 publications

Managing local‐regional failure in children with high‐risk neuroblastoma: A single institution experience

Managing local‐regional failure in children with high‐risk neuroblastoma: A single institution experience

Norepinephrine Transporter as a Target for Imaging and Therapy

The “neuro” of neuroblastoma: Neuroblastoma as a neurodevelopmental disorder

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