title: A systematic review of 131I-meta iodobenzylguanidine molecular radiotherapy for neuroblastoma.
abstract: The optimal use and effectiveness of (131)I-meta iodobenzylguanidine ((131)I-mIBG) molecular radiotherapy for neuroblastoma remain unclear despite extensive clinical experience. This systematic review aimed to improve understanding of the current data and define uncertainties for future clinical trials. Bibliographic databases were searched for neuroblastoma and (131)I-mIBG. Clinical trials and non-comparative case series of (131)I-mIBG therapy for neuroblastoma were included. Two reviewers assessed papers for inclusion using the title and abstract with consensus achieved by discussion. Data were extracted by one reviewer and checked by a second. Studies with multiple publications were reported as a single study. The searches yielded 1216 citations, of which 51 publications reporting 30 studies met our inclusion criteria. No randomised controlled trials (RCTs) were identified. In two studies (131)I-mIBG had been used as induction therapy and in one study it had been used as consolidation therapy. Twenty-seven studies for relapsed and refractory disease were identified. Publication dates ranged from 1987 to 2012. Total number of patients was 1121 with study sizes ranging from 10 to 164. There was a large amount of heterogeneity between the studies with regard to patient population, treatment schedule and response assessment. Study quality was highly variable. The objective tumour response rate reported in 25 studies ranged from 0% to 75%, mean 32%. We conclude that (131)I-mIBG is an active treatment for neuroblastoma, but its place in the management of neuroblastoma remains unclear. Prospective randomised trials are essential to strengthen the evidence base.
authors: Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, United Kingdom.
authors: Jayne S
authors: JS
authors: Wilson
authors: Department of Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, United Kingdom.
authors: Jennifer E
authors: JE
authors: Gains
authors: Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, United Kingdom.
authors: Veronica
authors: V
authors: Moroz
authors: Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, United Kingdom.
authors: Keith
authors: K
authors: Wheatley
authors: Department of Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, United Kingdom. Electronic address: mark.gaze@uclh.nhs.uk.
authors: Mark N
authors: MN
authors: Gaze
mesh_terms: D019797:3-Iodobenzylguanidine / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D009447:Neuroblastoma / Q000453:epidemiology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D012107:Research Design; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes; D019797:3-Iodobenzylguanidine
keywords: (131)I-meta iodobenzylguanidine; Clinical effectiveness; Molecular radiotherapy; Neuroblastoma; Radionuclide; Radiopharmaceutical; Systematic review