title: 131I-Metaiodobenzylguanidine therapy in children with advanced neuroblastoma.
abstract: Neuroblastoma is an aggressive childhood cancer, with a propensity for early widespread metastasis. Approximately 90% of tumors accumulate the norepinephrine analogue metaiodobenzylguanidine (MIBG) avidly, allowing the use of radiolabeled MIBG for targeted imaging and radiotherapy. After preclinical studies demonstrated activity of 131I-MIBG in models of neuroblastoma, clinical development of this agent ensued. Early clinical trials of 131I-MIBG in patients with relapsed or refractory neuroblastoma defined the toxicity profile of this agent, with myelosuppression as the main dose-limiting toxicity. Subsequent trials defined the activity of 131I-MIBG, with response rates of 20-40% in patients with relapsed or refractory disease. More recent clinical trials have tested 131I-MIBG in combination with chemotherapy or as a component of myeloablative therapies. Given the documented activity of 131I-MIBG, future studies will need to evaluate the impact of radiation sensitizers on this activity and define the role of this agent in treating patients with newly diagnosed high-risk neuroblastoma.
authors.affiliation: Department of Pediatrics, UCSF School of Medicine, San Francisco, CA, USA. duboiss@peds.ucsf.edu
authors.forename: S G
authors.initials: SG
authors.lastname: DuBois
authors.forename: K K
authors.initials: KK
authors.lastname: Matthay
mesh_terms: D019797:3-Iodobenzylguanidine / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism; D016543:Central Nervous System Neoplasms / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D003131:Combined Modality Therapy; D006801:Humans; D008495:Medical Oncology / Q000379:methods; D009447:Neuroblastoma / Q000628:therapy*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D012306:Risk; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine