Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 5/2010

01-05-2010 | Original Article

Efficacy of using a standard activity of 131I-MIBG therapy in patients with disseminated neuroendocrine tumours

Authors: Shaunak Navalkissoor, Dona M. Alhashimi, Ann-Marie Quigley, Martyn E. Caplin, John R. Buscombe

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2010

Login to get access

Abstract

Purpose

The aim of this analysis was to evaluate the response to standard activity of 131I-meta-iodobenzylguanidine (MIBG) in patients with disseminated neuroendocrine tumours (NETs), comparing overall survival of patients with symptomatic response, tumour size (as assessed by CT) and relevant plasma tumour markers.

Methods

A retrospective review of patients who had undergone 131I-MIBG treatment between March 2001 and December 2006 was carried out. The administered activity of 131I-MIBG was 5.5 GBq (NETs) and 7 GBq (phaeochromocytoma). Three cycles of treatment were planned with an interval of 10–12 weeks. A pre-therapy scan with 123I-MIBG was performed to ascertain appropriate biodistribution.

Results

Thirty-eight patients were identified. Only two patients developed significant bone marrow suppression. Symptomatic response: data were available in 37 of 38 patients: 15 patients had improved symptoms, 19 had no improvement in symptoms and 3 were asymptomatic. In those with a symptomatic response, the median overall survival was 58 months vs no response of 20.0 months (p = 0.001). CT response: in those with stable disease, the median overall survival was 58 months compared with progressive disease of 16.0 months. The difference between these groups was significant (p = 0.006). Hormonal response: this was available in only 20 of 38 patients. The median overall survival was the same for patients that had increased hormone levels and patients that had stable/decreased hormone levels (48 months).

Conclusion

Standard activity 131I-MIBG is well tolerated. Symptomatic response to treatment is a significant predictor of overall survival. Whilst CT response also appears to predict survival, hormonal levels do not appear to correlate with survival.
Literature
1.
Wieland DM, Swanson DP, Brown LE, Beierwaltes WH. Imaging the adrenal medulla with an I-131-labeled antiadrenergic agent. J Nucl Med 1979;20:155–8.PubMed
2.
Wafelman AR, Hoefnagel CA, Maes RA, Beijnen JH. Radioiodinated metaiodobenzylguanidine: a review of its biodistribution and pharmacokinetics, drug interactions, cytotoxicity and dosimetry. Eur J Nucl Med 1994;21:545–59.CrossRefPubMed
3.
Kaltsas G, Korbonits M, Heintz E, Mukherjee JJ, Jenkins PJ, Chew SL, et al. Comparison of somatostatin analog and meta-iodobenzylguanidine radionuclides in the diagnosis and localization of advanced neuroendocrine tumors. J Clin Endocrinol Metab 2001;86:895–902.CrossRefPubMed
4.
5.
Quigley AM, Buscombe JR, Shah T, Gnanasegaran G, Roberts D, Caplin ME, et al. Intertumoural variability in functional imaging within patients suffering from neuroendocrine tumours. An observational, cross-sectional study. Neuroendocrinology 2005;82(3–4):215–20.CrossRefPubMed
6.
McEwan AJ, Shapiro B, Sisson JC, Bierwaltes WH, Ackery DM. Radio-iodobenzylguanidine for the scintigraphic location and therapy of adrenergic tumors. Semin Nucl Med 1985;15:132–53.CrossRefPubMed
7.
Hoefnagel CA. Metaiodobenzylguanidine and somatostatin in oncology: role in the management of neural crest tumours. Eur J Nucl Med 1994;21:561–81.PubMed
8.
Loh KC, Fitzgerald PA, Matthy KK, Yeo PPB, Price DC. The treatment of malignant pheochromocytoma with iodine-131 metaiodobenzylguanidine (131I-MIBG): a comprehensive review of 116 reported patients. J Endocrinol Invest 1997;20:648–58.PubMed
9.
Buscombe JR, Cwikla JB, Caplin ME, Hilson AJ. Long-term efficacy of low activity meta-[131I]iodobenzylguanidine therapy in patients with disseminated neuroendocrine tumours depends on initial response. Nucl Med Commun 2005;26:969–76.CrossRefPubMed
10.
Safford SD, Coleman RE, Gockerman JP, Moore J, Feldman J, Onaitis MW, et al. Iodine-131 metaiodobenzylguanidine treatment for metastatic carcinoid. Results in 98 patients. Cancer 2004;101(9):1987–93.CrossRefPubMed
11.
Taal BG, Hoefnagel CA, Valdes Olmos RA, Boot H, Beijnen JH. Palliative effect of metaiodobenzylguanidine in metastatic carcinoid tumors. J Clin Oncol 1996;14:1829–38.PubMed
12.
Mukherjee JJ, Kaltsas GA, Islam N, Plowman PN, Foley R, Hikmat J, et al. Treatment of metastatic carcinoid tumours, phaeochromocytoma, paraganglioma and medullary carcinoma of the thyroid with 131I-metaiodobenzylguanidine (131I-mIBG). Clin Endocrinol (Oxf) 2001;55:47–60.CrossRef
13.
Bomanji J, Britton KE, Ur E, Hawkins L, Grossman AB, Besser GM. Treatment of malignant phaeochromocytoma, paraganglioma and carcinoid tumours with 131I-metaiodobenzylguanidine. Nucl Med Commun 1993;14:856–61.CrossRefPubMed
14.
Nwosu AC, Jones L, Vora J, Poston GJ, Vinjamuri S, Pritchard DM. Assessment of the efficacy and toxicity of (131)I-metaiodobenzylguanidine therapy for metastatic neuroendocrine tumours. Br J Cancer 2008;98:1053–8.CrossRefPubMed
15.
Sywak MS, Pasieka JL, McEwan A, Kline G, Rorstad O. 131I-meta-iodobenzylguanidine in the management of metastatic midgut carcinoid tumors. World J Surg 2004;28:1157–62.CrossRefPubMed
16.
17.
Fielding SL, Flower MA, Ackery D, Kemshead JT, Lashford LS, Lewis I. Dosimetry of iodine 131 metaiodobenzylguanidine for treatment of resistant neuroblastoma: results of a UK study. Eur J Nucl Med 1991;18:308–16.CrossRefPubMed
18.
Monsieurs M, Brans B, Bacher K, Dierckx R, Thierens H. Patient dosimetry for 131I-MIBG therapy for neuroendocrine tumours based on 123I-MIBG scans. Eur J Nucl Med Mol Imaging 2002;29(12):1581–7.CrossRefPubMed
19.
Modlin IM, Latich I, Zikusoka M, Kidd M, Eick G, Chan AK. Gastrointestinal carcinoids: the evolution of diagnostic strategies. J Clin Gastroenterol 2006;40:572–82.CrossRefPubMed
20.
Paganelli G, Bodei L, Handkiewicz Junak D, Rocca P, Papi S, Lopera Sierra M, et al. 90Y-DOTA-D-Phe1-Tyr3-octreotide in therapy of neuroendocrine malignancies. Biopolymers 2002;66:393–8.CrossRefPubMed
21.
Kwekkeboom DJ, de Herder WW, Kam BL, van Eijck CH, van Essen M, Kooij PP, et al. Treatment with the radiolabeled somatostatin analog [177Lu-DOTA0,Tyr3]octreotate: toxicity, efficacy, and survival. J Clin Oncol 2008;26:2124–30.CrossRefPubMed
22.
Madsen M, Bushnell D, Juweid ME, Menda Y, O’Dorisio MS, O’Dorisio T, et al. Potential increased tumor-dose delivery with combined 131I-MIBG and 90Y-DOTATOC treatment in neuroendocrine tumors: a theoretic model. J Nucl Med 2006;47:660–7.PubMed
Metadata
Title
Efficacy of using a standard activity of 131I-MIBG therapy in patients with disseminated neuroendocrine tumours
Authors
Shaunak Navalkissoor
Dona M. Alhashimi
Ann-Marie Quigley
Martyn E. Caplin
John R. Buscombe
Publication date
01-05-2010
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2010
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-009-1326-3

Other articles of this Issue 5/2010

European Journal of Nuclear Medicine and Molecular Imaging 5/2010 Go to the issue

Original Article

High throughput static and dynamic small animal imaging using clinical PET/CT: potential preclinical applications

Letter to the Editor

Reply to: Can an undetectable value of TG and a negative neck ultrasound study be considered reliable methods to assess the completeness of thyroid ablation?

Original Article

Dose-response assessment of tariquidar and elacridar and regional quantification of P-glycoprotein inhibition at the rat blood-brain barrier using (R)-[11C]verapamil PET

Original Article

Dosimetry-guided high-activity 131I therapy in patients with advanced differentiated thyroid carcinoma: initial experience

Image of the Month

High-resolution 18F-FDG PET with MRI for monitoring response to treatment in rheumatoid arthritis

Original Article

In vivo imaging of neuroinflammation: a comparative study between [18F]PBR111, [11C]CLINME and [11C]PK11195 in an acute rodent model