Annals of Oncology 11:1437-1443, 2000
© 2000 European Society for Medical Oncology
research-article |
Improved effect of 131I-MIBG treatment by predosing with non-radiolabeled MIBG in carcinoid patients, and studies in xenografted mice
1Department of Gastroenterology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis Amsterdam, The Netherlands
2Department of Nuclear Medicine, Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis Amsterdam, The Netherlands
3Department of Experimental Therapy, Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis Amsterdam, The Netherlands
Correspondence to: B. G. Taal, MD, PhD Department of Gastroenterology Netherlands Cancer Institute/Antoni van Leeuwenhoekhuis Plesmanlaan 121 1066 CX Amsterdam The Netherlands E-mail: b_taal{at}nki.nl
BACKGROUND: 131I-meta-iodobenzylguanidine (MIBG)has been used with success for the palliation of metastatic carcinoid. To qualify more patients for this treatment, we evaluated the effect of predosing with non-radiolabeled MIBG on 131I-MIBG tumour targeting in carcinoid patients and in mice with BON human carcinoid xenografts.
PATIENTS AND METHODS: Ten carcinoid patients with a faint tumour imaging on a diagnostic 131I-MIBG scan (1 mCi = 37 MBq, 5 mg MIBG) received non-radiolabeled MIBG prior to a second scintigraphy. In case of improved tumour targeting patients were treated with 200 mCi (7.4 GBq) 131I-MIBG following a pharmacological predose of 20–40 mg/m2 MIBG.
RESULTS: In six patients, highly increased ‘tumour/non tumour’ ratios were seen due to reduced levels in normal tissues and increased tumour accumulation. The combined treatment applied in five patients, considerably improved symptoms in all (duration 6–12 months), accompanied by biochemical response in three. In BON carcinoid xenografted mice, MIBG was injected intraperitoneally followed by intravenous 125I-MIBG with similar findings: increased ‘tumour/non-tumour’ radioactivity ratios by 1.5–3-fold.
CONCLUSIONS: Predosing with non-radiolabeled MIBG resulted in improved 131I-MIBG tumour targeting, prolonged palliation and encouragingly often biochemical responses in carcinoid.
biodistribution, carcinoid tumours, MIBG, tumour targeting
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