Feasibility, toxicity and response of upfront metaiodobenzylguanidine therapy therapy followed by German Pediatric Oncology Group Neuroblastoma 2004 protocol in newly diagnosed stage 4 neuroblastoma patients

K C J M Kraal, G M Bleeker, B L F van Eck-Smit, N K A van Eijkelenburg, F Berthold, M M van Noesel, H N Caron, G A M Tytgat

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)

Abstract

AIM OF THE STUDY: Radiolabelled meta-iodobenzylguanidine (MIBG) is an effective option in treatment of neuroblastoma (NBL) tumours. We studied feasibility, toxicity and efficacy of upfront 131I-MIBG and induction treatment in stage 4 NBL patients.

PATIENTS AND METHODS: Retrospective, multi-centre (AMC and EMC) pilot regimen (1/1/2005-2011). Newly diagnosed stage 4 NBL patients, were treated with 2 courses of 131I-MIBG, GPOH 2004 NBL protocol, myeloablative therapy (MAT) and autologous stem cell rescue (ASCT). 131I-MIBG was administered in a fixed dose. Response rate (RR) was defined as complete remission, very good partial response and partial response.

RESULTS: Thirty-two patients, (median age [range] 2.9 [0-11.4] years), 21 received 131I-MIBG therapy, 11 did not because of: MIBG non-avid (N = 5) and poor clinical condition (N = 6). In 95% of eligible patients 131I-MIBG treatment was feasible within 2 weeks from diagnosis. Interval between chemotherapy courses was 25 days (131I-MIBG group) versus 22 days (chemotherapy group). No stem cell support was needed after 131I-MIBG therapy. Stem cell harvest in both groups was feasible, neutrophil recovery was comparable, but platelet recovery post MAT, ASCT was slower for 131I-MIBG-treated patients. RR post 131I-MIBG was 38%, post MAT + ASCT was 71% (131I-MIBG group), 36% (chemotherapy group) and overall 59%.

CONCLUSIONS: Induction therapy with 131I-MIBG before the HR GPOH NB 2004 protocol is feasible, tolerable and effective in newly diagnosed stage 4 NBL patients. 131I-MIBG upfront therapy induces early responses.

Original languageEnglish
Pages (from-to)188-196
Number of pages9
JournalEuropean Journal of Cancer
Volume76
DOIs
Publication statusPublished - Mar 2017

Keywords

  • 3-Iodobenzylguanidine/therapeutic use
  • Abdominal Neoplasms/drug therapy
  • Antineoplastic Agents/therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Child
  • Child, Preschool
  • Feasibility Studies
  • Female
  • Humans
  • Induction Chemotherapy/methods
  • Infant
  • Infant, Newborn
  • Male
  • Myeloablative Agonists/therapeutic use
  • Neoplasm Staging
  • Neuroblastoma/drug therapy
  • Pilot Projects
  • Retrospective Studies
  • Stem Cell Transplantation
  • Surgical Procedures, Operative
  • Thoracic Neoplasms/drug therapy
  • Time Factors
  • Transplantation, Autologous

Fingerprint

Dive into the research topics of 'Feasibility, toxicity and response of upfront metaiodobenzylguanidine therapy therapy followed by German Pediatric Oncology Group Neuroblastoma 2004 protocol in newly diagnosed stage 4 neuroblastoma patients'. Together they form a unique fingerprint.

Cite this