Iodine -131 metaiodobenzylguanidine is an effective treatment for malignant pheochromocytoma and paraganglioma

Safford, Shawn D.; Coleman, Robert E.; Gockerman, Jon P.; Moore, Joseph O.; Feldman, Jerome M.; Leight, George S.; Tyler, Douglas S.; Olson, John A.

doi:10.1016/s0039-6060(03)00426-4

Cited by 137 publications

(99 citation statements)

References 10 publications

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“…In those patients with a response or stable disease at 6 months after the last treatment, a prolonged progression-free survival was seen; however, in another series 72% of patients developed progression of the disease at 18 months after an initial response (Buscombe et al 2005). Apart from the total administered dose and response to therapy, the initial 131 I-MIBG dose could be an important determinant of patient's response and survival, as patients who received high initial doses (O500 mCi) lived longer than those who received lower doses (Safford et al 2003). More recently, higher single doses of 131 I-MIBG, ranging from 386 to 866 mCi, were administered in 12 patients (Rose et al 2003).…”

Section: Surgery Of the Primary Tumour And Cytoreductive Techniquesmentioning

confidence: 99%

The diagnosis and management of malignant phaeochromocytoma and paraganglioma

Chrisoulidou

Kaltsas²,

Ilias³

et al. 2007

Endocr Relat Cancer

295

219

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Malignant phaeochromocytomas are rare tumours accounting for w10% of all phaeochromocytomas; the prevalence of malignancy among paragangliomas is higher, especially those associated with succinate dehydrogenase subunit B gene mutations. Although a subset of these tumours has metastatic disease at initial presentation, a significant number develops metastases during follow-up after excision of an apparently benign tumour. Clinical, biochemical and histological features cannot reliably distinguish malignant from benign tumours. Although a number of recently introduced molecular markers have been explored, their clinical significance remains to be elucidated from further studies. Several imaging modalities have been utilised for the diagnosis and staging of these tumours. Functional imaging using radiolabelled metaiodobenzylguanidine (MIBG) and more recently, 18 F-fluorodopamine and 18 F-fluorodopa positron emission tomography offer substantial sensitivity and specificity to correctly detect metastatic phaeochromocytoma and paraganglioma and helps identify patients suitable for treatment with radiopharmaceuticals. The 5-year mortality rate of patients with malignant phaeochromocytomas and paragangliomas greater than 50% indicates that there is considerable room for the improvement of currently available therapies. The main therapeutic target is tumour reduction and control of symptoms of excessive catecholamine secretion. Currently, the best adjunctive therapy to surgery is treatment with radiopharmaceuticals using 131 I-MIBG; however, this is very rarely curative. Chemotherapy has been used for metastatic disease with only a partial and mainly palliative effect. The role of other forms of radionuclide treatment either alone or in combination with chemotherapy is currently evolving. Ongoing microarray studies may provide novel intracellular pathways of importance for proliferation/cell cycle control, and lead to the development of novel pharmacological agents.

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Section: Surgery Of the Primary Tumour And Cytoreductive Techniquesmentioning

confidence: 99%

The diagnosis and management of malignant phaeochromocytoma and paraganglioma

Chrisoulidou

Kaltsas²,

Ilias³

et al. 2007

Endocr Relat Cancer

295

219

View full text Add to dashboard Cite

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“…Hormonal crises due to excessive catecholamine secretion in patients with metastatic paraganglioma can lead to hypertension, hypotension, myocardial ischemia, pulmonary edema and shock [19], and such crises have been reported with 131 I-MIBG therapy [20][21][22]. Safford et al also reported two deaths from myocardial infarction following high dose 131 I-MIBG therapy with a dose of 300 mCi (11.1 GBq) [22].…”

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confidence: 99%

“…Safford et al also reported two deaths from myocardial infarction following high dose 131 I-MIBG therapy with a dose of 300 mCi (11.1 GBq) [22]. However, a 177 Lu-DOTATATE treatment-induced catecholamine crisis in a pheochromocytoma or paraganglioma patient has been described in only one case of malignant pheochromocytoma, in which the patient developed hypotension, excessive sweating and cardiac ischemia 1 day after 177 Lu-DOTATATE therapy [23].…”

mentioning

confidence: 99%

The Challenges of Treating Paraganglioma Patients with 177Lu-DOTATATE PRRT: Catecholamine Crises, Tumor Lysis Syndrome and the Need for Modification of Treatment Protocols

Makis¹,

McCann²,

McEwan³

2015

Nucl Med Mol Imaging

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Purpose A high percentage of paragangliomas express somatostatin receptors that can be utilized for targeted radioisotope therapy. The aim of this study was to describe and discuss the challenges of treating these tumors with 177 Lu-[DOTA 0 ,Tyr 3 ]octreotate (DOTATATE) radioisotope therapy using established protocols. Methods and Results Three paraganglioma patients were treated with 4-5 cycles of 177

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“…It is thought that emission of ionising radiation at this site results in tumour decay (Mukherjee et al, 2001;Rose et al, 2003;Pasieka et al, 2004). This therapy has been used to treat NETs of various types, including gastroenteropancreatic NETs (Pathirana et al, 2001;Pasieka et al, 2004;Safford et al, 2004;Sywak et al, 2004;Buscombe et al, 2005), paraglangliomas (Mukherjee et al, 2001;Safford et al, 2003;Fitzgerald et al, 2006), phaeochromocytomas (Castellani et al, 2000;Rose et al, 2003;Safford et al, 2004;Fitzgerald et al, 2006), medullary carcinoma of the thyroid (Castellani et al, 2000(Castellani et al, , 2003Mukherjee et al, 2001) and neuroblastomas (Howard et al, 2005;Matthay et al, 2007). A number of previous studies had demonstrated significant symptomatic benefit in 40 -60% of patients with metastatic NETs following 131 I-MIBG therapy (Safford et al, 2004;Sywak et al, 2004), in a safe and cost-effective manner (Pathirana et al, 2001).…”

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confidence: 99%

Assessment of the efficacy and toxicity of 131I-metaiodobenzylguanidine therapy for metastatic neuroendocrine tumours

et al. 2008

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131 I-metaiodobenzylguanidine ( 131 I-MIBG) is a licensed palliative treatment for patients with metastatic neuroendocrine tumours. We have retrospectively assessed the consequences of 131 I-MIBG therapy in 48 patients (30 gastroenteropancreatic, 6 pulmonary, 12 unknown primary site) with metastatic neuroendocrine tumours attending Royal Liverpool University Hospital between 1996 and 2006. Mean age at diagnosis was 57.6 years (range 34 -81). 131 I-MIBG was administered on 88 occasions (mean 1.8 treatments, range 1 -4). Twenty-nine patients had biochemical markers measured before and after 131 I-MIBG, of whom 11 (36.7%) showed 450% reduction in levels post-therapy. Forty patients had radiological investigations performed after 131 I-MIBG, of whom 11(27.5%) showed reduction in tumour size post-therapy. Twenty-seven (56.3%) patients reported improved symptoms after 131 I-MIBG therapy. Kaplan -Meier analysis showed significantly increased survival (P ¼ 0.01) from the date of first 131 I-MIBG in patients who reported symptomatic benefit from therapy. Patients with biochemical and radiological responses did not show any statistically significant alteration in survival compared to non-responders. Eleven (22.9%) patients required hospitalisation as a consequence of complications, mostly due to mild bone marrow suppression. 131 I-MIBG therefore improved symptoms in more than half of the patients with metastatic neuroendocrine tumours and survival was increased in those patients who reported a symptomatic response to therapy.

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Iodine -131 metaiodobenzylguanidine is an effective treatment for malignant pheochromocytoma and paraganglioma

Cited by 137 publications

References 10 publications

The diagnosis and management of malignant phaeochromocytoma and paraganglioma

The diagnosis and management of malignant phaeochromocytoma and paraganglioma

The Challenges of Treating Paraganglioma Patients with 177Lu-DOTATATE PRRT: Catecholamine Crises, Tumor Lysis Syndrome and the Need for Modification of Treatment Protocols

Assessment of the efficacy and toxicity of 131I-metaiodobenzylguanidine therapy for metastatic neuroendocrine tumours

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