Addition of 131I-MIBG to PRRT (90Y-DOTATOC) for Personalized Treatment of Selected Patients with Neuroendocrine Tumors

David L Bushnell; Kellie L Bodeker; Thomas M O'Dorisio; Mark T Madsen; Yusuf Menda; Stephen Graves; Gideon KD Zamba; M Sue O'Dorisio

doi:10.2967/jnumed.120.254987

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Addition of 131I-MIBG to PRRT (90Y-DOTATOC) for Personalized Treatment of Selected Patients with Neuroendocrine Tumors

Journal article

Open access

Peer reviewed

Addition of 131I-MIBG to PRRT (90Y-DOTATOC) for Personalized Treatment of Selected Patients with Neuroendocrine Tumors

David L Bushnell, Kellie L Bodeker, Thomas M O'Dorisio, Mark T Madsen, Yusuf Menda, Stephen Graves, Gideon KD Zamba and M Sue O'Dorisio

The Journal of nuclear medicine (1978), Vol.62(9), pp.1274-1277

09/01/2021

DOI: 10.2967/jnumed.120.254987

PMCID: PMC8882893

PMID: 33517327

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Abstract

Peptide receptor radionuclide therapy (PRRT) is an effective treatment for metastatic neuroendocrine tumors. Delivering a sufficient tumor radiation dose remains challenging because of critical-organ dose limitations. Adding 131I-metaiodobenzylguanidine (131I-MIBG) to PRRT may be advantageous in this regard. Methods: A phase 1 clinical trial was initiated for patients with nonoperable progressive neuroendocrine tumors using a combination of 90Y-DOTATOC plus 131I-MIBG. Treatment cohorts were defined by radiation dose limits to the kidneys and the bone marrow. Subject-specific dosimetry was used to determine the administered activity levels. Results: The first cohort treated subjects to a dose limit of 1,900 cGy to the kidneys and 150 cGy to the marrow. No dose-limiting toxicities were observed. Tumor dosimetry estimates demonstrated an expected dose increase of 34%–83% using combination therapy as opposed to 90Y-DOTATOC PRRT alone. Conclusion: These findings demonstrate the feasibility of using organ dose for a phase 1 escalation design and suggest the safety of using 90Y-DOTATOC and 131I-MIBG.

Bone Marrow

Dosimetry

Radioisotopes

Tumors

Dosimeters

Kidneys

Metastases

Neuroendocrine tumors

Patients

Radiation

Radiation dosage

Radiation therapy

Toxicity

Yttrium isotopes

Details

Title: Subtitle: Addition of 131I-MIBG to PRRT (90Y-DOTATOC) for Personalized Treatment of Selected Patients with Neuroendocrine Tumors
Creators: David L Bushnell - University of Iowa
Kellie L Bodeker - University of Iowa
Thomas M O'Dorisio - University of Iowa
Mark T Madsen - University of Iowa
Yusuf Menda - University of Iowa
Stephen Graves - University of Iowa
Gideon KD Zamba - University of Iowa
M Sue O'Dorisio - University of Iowa
Resource Type: Journal article
Publication Details: The Journal of nuclear medicine (1978), Vol.62(9), pp.1274-1277
DOI: 10.2967/jnumed.120.254987
PMID: 33517327
PMCID: PMC8882893
NLM abbreviation: J Nucl Med
ISSN: 0161-5505
eISSN: 1535-5667
Publisher: Society of Nuclear Medicine
Language: English
Date published: 09/01/2021
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Stead Family Department of Pediatrics; Biostatistics; Radiation Oncology; Endocrinology and Metabolism; Internal Medicine
Record Identifier: 9984226812302771

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