Treatment of advanced neuroblastoma in children over 1 year of age: The critical role of (131) I-metaiodobenzylguanidine combined with chemotherapy in a rapid induction regimen.

Mastrangelo, Stefano; Rufini, Vittoria; Ruggiero, Antonio; Di Giannatale, Angela; Riccardi, Riccardo

doi:10.1002/pbc.22986

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BACKGROUND: The prognosis of patients with advanced neuroblastoma (NB) remains poor. Major and early responses have an important bearing on treatment outcome. Iodine-131-metaiodobenzylguanidine (¹³¹I-MIBG) has the potential to deliver large doses of radiation specifically to NB cells. We evaluated the toxicity of, and response to, a novel induction regimen that included ¹³¹I-MIBG combined with cisplatin, cyclophosphamide, etoposide, vincristine, and doxorubicin. PROCEDURE: Thirteen children over 1 year of age with advanced NB at diagnosis were investigated extensively. ¹³¹I-MIBG was administered on day 10; this was preceded by chemotherapy in the five patients in group 1 (described in our previous study), and both preceded and followed by chemotherapy in the eight patients in group 2. The final induction regimen (used for group 2) lasted 1 month. Evaluation was performed 40 days after the start of treatment. RESULTS: In both groups 1 and 2, the extent of hematologic toxicity, which was the only side effect, was similar to that seen with chemotherapy alone. Doses of ¹³¹I-MIBG as high as 16.6 mCi/kg showed no evidence of toxicity, even in patients with extensive bone marrow infiltration. Overall, we recorded two patients with a complete response (CR), six very good partial responses (VGPR), four partial responses (PR), and one mixed response (MR). In group 2, CR/VGPR were observed in patients treated with higher doses of ¹³¹I-MIBG. CONCLUSIONS: The results of this pilot study show that ¹³¹I-MIBG, in combination with chemotherapy, appears to play an important role in a new and effective induction regimen for advanced NB.

Mastrangelo, S., Rufini, V., Ruggiero, A., Di Giannatale, A., Riccardi, R., Treatment of advanced neuroblastoma in children over 1 year of age: The critical role of (131) I-metaiodobenzylguanidine combined with chemotherapy in a rapid induction regimen., <<PEDIATRIC BLOOD & CANCER>>, 2011; 56 (7): 1032-1040. [doi:10.1002/pbc.22986] [http://hdl.handle.net/10807/12185]

Autori:	Mastrangelo, Stefano Rufini, Vittoria Ruggiero, Antonio Di Giannatale, Angela Riccardi, Riccardo
Titolo:	Treatment of advanced neuroblastoma in children over 1 year of age: The critical role of (131) I-metaiodobenzylguanidine combined with chemotherapy in a rapid induction regimen.
Digital Object Identifier (DOI):	http://dx.doi.org/10.1002/pbc.22986
Data di pubblicazione:	2011
Abstract:	BACKGROUND: The prognosis of patients with advanced neuroblastoma (NB) remains poor. Major and early responses have an important bearing on treatment outcome. Iodine-131-metaiodobenzylguanidine (¹³¹I-MIBG) has the potential to deliver large doses of radiation specifically to NB cells. We evaluated the toxicity of, and response to, a novel induction regimen that included ¹³¹I-MIBG combined with cisplatin, cyclophosphamide, etoposide, vincristine, and doxorubicin. PROCEDURE: Thirteen children over 1 year of age with advanced NB at diagnosis were investigated extensively. ¹³¹I-MIBG was administered on day 10; this was preceded by chemotherapy in the five patients in group 1 (described in our previous study), and both preceded and followed by chemotherapy in the eight patients in group 2. The final induction regimen (used for group 2) lasted 1 month. Evaluation was performed 40 days after the start of treatment. RESULTS: In both groups 1 and 2, the extent of hematologic toxicity, which was the only side effect, was similar to that seen with chemotherapy alone. Doses of ¹³¹I-MIBG as high as 16.6 mCi/kg showed no evidence of toxicity, even in patients with extensive bone marrow infiltration. Overall, we recorded two patients with a complete response (CR), six very good partial responses (VGPR), four partial responses (PR), and one mixed response (MR). In group 2, CR/VGPR were observed in patients treated with higher doses of ¹³¹I-MIBG. CONCLUSIONS: The results of this pilot study show that ¹³¹I-MIBG, in combination with chemotherapy, appears to play an important role in a new and effective induction regimen for advanced NB.
Lingua:	Inglese
Rivista:	PEDIATRIC BLOOD & CANCER
Citazione:	Mastrangelo, S., Rufini, V., Ruggiero, A., Di Giannatale, A., Riccardi, R., Treatment of advanced neuroblastoma in children over 1 year of age: The critical role of (131) I-metaiodobenzylguanidine combined with chemotherapy in a rapid induction regimen., <<PEDIATRIC BLOOD & CANCER>>, 2011; 56 (7): 1032-1040. [doi:10.1002/pbc.22986] [http://hdl.handle.net/10807/12185]
Appare nelle tipologie:	Articolo in rivista, Nota a sentenza

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