Upfront consolidation treatment with 131I‐mIbG followed by myeloablative chemotherapy and hematopoietic stem cell transplantation in high‐risk neuroblastoma. Issue 3 (27th September 2020)

• Record Type: Journal Article
• Authors: Feng, Jianhua; Cheng, Frankie WT; Leung, Alex WK; Lee, Vincent; Yeung, Eva WM; Ching Lam, Hoi; Cheung, Jeanny; Lam, Grace KS; Chow, Terry TW; Yan, Carol LS; Kong Li, Chi
• Is Part Of: Pediatric investigation. Volume 4:Issue 3(2020)
• Page Start: 168
• Page End: 177
• Publication Date: 2020-09-27
• Subjects: Neuroblastoma -- 131I‐mIBG -- Transplantation; Pediatrics -- Periodicals; Pediatrics -- Research -- Periodicals; 618.920005
• DOI: 10.1002/ped4.12216
• Languages: English
• ISSNs: 2574-2272

Abstract

Abstract: Importance: 131 I‐metaiodobenzylguanidine ( 131 I‐mIBG) has a significant targeted antitumor effect for neuroblastoma. However, currently there is a paucity of data for the use of 131 I‐mIBG as a "front‐line" therapeutic agent in those patients with newly diagnosed high‐risk neuroblastoma as part of the conditioning regimen for myeloablative chemotherapy (MAC). Objective: To evaluate the feasibility of upfront consolidation treatment with 131 I‐mIBG plus MAC and hematopoietic stem cell transplantation (HSCT) in high‐risk neuroblastoma patients. Methods: A retrospective, single‐center study was conducted from 2003–2019 on newly diagnosed high‐risk neuroblastoma patients without progressive disease (PD) after the completion of induction therapy. They received 131 I‐mIBG infusion and MAC followed by HSCT. Results: A total of 24 high‐risk neuroblastoma patients were enrolled with a median age of 3.0 years at diagnosis. After receiving this sequential consolidation treatment, 3 of 13 patients who were in partial response (PR) before 131 I‐mIBG treatment achieved either complete response (CR) ( n = 1) or very good partial response (VGPR) ( n = 2) after HSCT. With a median follow‐up duration of 13.0 months after 131 I‐mIBG therapy, the 5‐year event‐free survival and overall survival rates estimated were 29% and 38% for the entire cohort, and 53% and 67% for the patients who were in CR/VGPR at the time of 131 I‐mIBG treatment. Interpretation: Upfront consolidation treatment with 131 I‐mIBG plus MAC and HSCT is feasible and tolerable in high‐risk neuroblastoma patients, however the survival benefit of this 131 I‐mIBG regimen is only observed in the patients who were in CR/VGPR at the time of 131 I‐mIBG treatment. Abstract : Upfront consolidation treatment with 131I‐mIBG plus myeloablative chemotherapy (MAC) and hematopoietic stem cell transplantation (HSCT) is feasible in high‐risk neuroblastoma patients, and the better survival benefit of this 131I‐mIBG regimen is observed in the patients who were in complete response (CR)/very good partial response (VGPR) at the time of 131I‐mIBG treatment.