Journal of Clinical Oncology, Vol 10, 1889-1896, Copyright © 1992 by American Society of Clinical Oncology
Phase I/II study of iodine 131 metaiodobenzylguanidine in chemoresistant neuroblastoma: a United Kingdom Children's Cancer Study Group investigation
LS Lashford, IJ Lewis, SL Fielding, MA Flower, S Meller, JT Kemshead and D Ackery
Department of Paediatric Oncology, St James's University Hospital, Leeds, United Kingdom.
PURPOSE: The goal of this study was to evaluate the toxicity of iodine 131
metaiodobenzylguanidine (mIBG) in metastatic neuroblastoma. PATIENTS AND
METHODS: A multicenter phase I study of 131I mIBG has been undertaken by
the United Kingdom Children's Cancer Study Group (UKCCSG) in children with
advanced chemoresistant neuroblastoma. Activity prescription was based on a
prescribed whole-body radiation dose, which was established for individual
patients by performing an initial tracer investigation with 75 MBq of 131I
mIBG. An activity was derived from this pharmacokinetic study that would
deliver an initial whole-body- absorbed radiation dose of 1 Gy. Subsequent
dose escalations were based on observed toxicity. RESULTS: Twenty-five
patients, aged 1 to 10 years, were treated with prescribed whole-body dose
levels of 1.0 Gy (n = 2), 2.0 Gy (n = 13), and 2.5 Gy (n = 10). This
necessitated administration of 2.4 to 12.1 GBq of activity. Hematologic,
hepatic, kidney, and adrenal toxicity were observed, with bone marrow
suppression being the principal dose-limiting toxicity. Bone marrow
toxicity increased with prescribed whole-body-absorbed radiation dose, with
80% of patients developing grade 3 or 4 thrombocytopenia at a prescribed
whole-body radiation dose of 2.5 Gy. Objective evidence of tumor response
was seen in soft tissue (primary or nodal disease), bone, and bone marrow,
with an overall response rate of 33% (partial response, n = 8; static
disease, n = 9; progressive disease, n = 7). CONCLUSIONS: This study has
established an effective method of activity prescription that predicts
subsequent toxicity, with the maximally tolerated dose being sufficient
activity to deliver a whole-body- absorbed radiation dose of 2.5 Gy. The
objective response rate is comparable to other single agents in
chemoresistant neuroblastoma and suggests that 131I mIBG may be a useful
method for targeting radiotherapy in metastatic neuroblastoma.
This article has been cited by other articles:
|
|
|
|
 
A G McCluskey, M Boyd, S L Pimlott, J W Babich, M N Gaze, and R J Mairs
Experimental treatment of neuroblastoma using [131I]meta-iodobenzylguanidine and topotecan in combination
Br. J. Radiol.,
October 1, 2008;
81(Special_Issue_1):
S28 - S35.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Khanna, D. Bushnell, and M. S. O'Dorisio
Utility of Radiolabeled Somatostatin Receptor Analogues for Staging/Restaging and Treatment of Somatostatin Receptor-Positive Pediatric Tumors
Oncologist,
April 1, 2008;
13(4):
382 - 389.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. J. G. Oyen, L. Bodei, F. Giammarile, H. R. Maecke, J. Tennvall, M. Luster, and B. Brans
Targeted therapy in nuclear medicine current status and future prospects
Ann. Onc.,
November 1, 2007;
18(11):
1782 - 1792.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. K. Matthay, G. Yanik, J. Messina, A. Quach, J. Huberty, S.-C. Cheng, J. Veatch, R. Goldsby, P. Brophy, L. S. Kersun, et al.
Phase II Study on the Effect of Disease Sites, Age, and Prior Therapy on Response to Iodine-131-Metaiodobenzylguanidine Therapy in Refractory Neuroblastoma
J. Clin. Oncol.,
March 20, 2007;
25(9):
1054 - 1060.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Boyd, S. C. Ross, J. Dorrens, N. E. Fullerton, K. W. Tan, M. R. Zalutsky, and R. J. Mairs
Radiation-Induced Biologic Bystander Effect Elicited In Vitro by Targeted Radiopharmaceuticals Labeled with {alpha}-, {beta}-, and Auger Electron-Emitting Radionuclides
J. Nucl. Med.,
June 1, 2006;
47(6):
1007 - 1015.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. T. Madsen, D. L. Bushnell, M. E. Juweid, Y. Menda, M. S. O'Dorisio, T. O'Dorisio, and I. M. Besse
Potential Increased Tumor-Dose Delivery with Combined 131I-MIBG and 90Y-DOTATOC Treatment in Neuroendocrine Tumors: A Theoretic Model
J. Nucl. Med.,
April 1, 2006;
47(4):
660 - 667.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. P. Lee, J. M. Skolnik, and P. C. Adamson
Pediatric Phase I Trials in Oncology: An Analysis of Study Conduct Efficiency
J. Clin. Oncol.,
November 20, 2005;
23(33):
8431 - 8441.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. G. McCluskey, M. Boyd, S. C. Ross, E. Cosimo, A. M. Clark, W. J. Angerson, M. N. Gaze, and R. J. Mairs
[131I]meta-Iodobenzylguanidine and Topotecan Combination Treatment of Tumors Expressing the Noradrenaline Transporter
Clin. Cancer Res.,
November 1, 2005;
11(21):
7929 - 7937.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. H. Kushner
Neuroblastoma: A Disease Requiring a Multitude of Imaging Studies
J. Nucl. Med.,
July 1, 2004;
45(7):
1172 - 1188.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. G. DuBois, J. Messina, J. M. Maris, J. Huberty, D. V. Glidden, J. Veatch, M. Charron, R. Hawkins, and K. K. Matthay
Hematologic Toxicity of High-Dose Iodine-131-Metaiodobenzylguanidine Therapy for Advanced Neuroblastoma
J. Clin. Oncol.,
June 15, 2004;
22(12):
2452 - 2460.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. K. Matthay, C. Panina, J. Huberty, D. Price, D. V. Glidden, H. R. Tang, R. A. Hawkins, J. Veatch, and B. Hasegawa
Correlation of Tumor and Whole-Body Dosimetry with Tumor Response and Toxicity in Refractory Neuroblastoma Treated with 131I-MIBG
J. Nucl. Med.,
November 1, 2001;
42(11):
1713 - 1721.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. J. Estlin, S. Cotterill, C. B. Pratt, A. D. J. Pearson, and M. Bernstein
Phase I Trials in Pediatric Oncology: Perceptions of Pediatricians From the United Kingdom Children's Cancer Study Group and the Pediatric Oncology Group
J. Clin. Oncol.,
May 9, 2000;
18(9):
1900 - 1905.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. MELLER
Targeted radiotherapy for neuroblastoma
Arch. Dis. Child.,
November 1, 1997;
77(5):
389 - 392.
[Full Text]
|
|
|
|
