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Long-term outcomes of 131Iodine mIBG therapy in metastatic gastrointestinal pancreatic neuroendocrine tumours: single administration predicts non-responders

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Background

131Iodine (I131)-metaiodobenzylguanidine (mIBG) is a radionuclide-based treatment option for metastatic gastrointestinal-pancreatic neuroendocrine tumours (GEP NET). This study aimed at identifying prognostic indicators of long-term outcome based on initial evaluation following a first mIBG treatment (7400 MBq) in a patient cohort with such tumours, with a secondary aim of evaluating progression-free survival (PFS) and overall survival (OS) following mIBG therapy.

Methods

Retrospective review of the hospital records was performed to identify a cohort of 38 adult patients who underwent 131Iodine-mIBG therapy over a 9-year period for metastatic GEP NETs and neuroendocrine tumours with an unknown primary. Treatment response was evaluated based on radiological criteria (RECIST1.1), biochemical markers [serum Chromogranin A (CgA)/urinary 5HIAA] and symptomatic response at clinical follow-up, all evaluated at 3–6 months from first mIBG treatment. Progression-free survival (PFS) and overall survival (OS) from the first mIBG treatment were recorded.

Results

At 3–6 months following a single mIBG therapy, 75 %, 67 %, and 63 % of patients showed either a partial response (PR) or stable disease (SD) on radiological, biochemical, and symptomatic criteria, respectively. Complete response (CR) was not seen in any patient. OS from the date of diagnosis and from the first therapy was 8 years +/−1.1 (95 % CI 5.7 to 10.2 years) and 4 years+/−0.69 (95 % CI 2.6–5.3 years), respectively. Twenty-nine percent of patients were alive at 10 years. Significant survival advantage was seen in patients with SD/PR as compared to those who had progressive disease (PD) for each of these three criteria.

Conclusion

Biochemical, radiological (RECIST 1.1) and symptomatic assessment of disease status at 3 to 6 months after first I131-mIBG therapy stratifies patients with a poor prognosis. This can be used to identify patients who may benefit from alternative strategies of treatment.

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Acknowledgments

Dr. M Buxton-Thomas, Dr. J Ramage

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

For this type of study formal consent is not required.

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Authors and Affiliations

  1. Department of Nuclear Medicine, King’s College Hospital, Denmark Hill, London, SE5 9RS, UK

    Nicola Mulholland, Riddhika Chakravartty, Lindsey Devlin, Eleni Kalogianni, Ben Corcoran & Gillian Vivian

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  1. Nicola Mulholland
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  2. Riddhika Chakravartty
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  3. Lindsey Devlin
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  4. Eleni Kalogianni
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  5. Ben Corcoran
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Correspondence to Nicola Mulholland.

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Mulholland, N., Chakravartty, R., Devlin, L. et al. Long-term outcomes of 131Iodine mIBG therapy in metastatic gastrointestinal pancreatic neuroendocrine tumours: single administration predicts non-responders. Eur J Nucl Med Mol Imaging 42, 2002–2012 (2015). https://doi.org/10.1007/s00259-015-3116-4

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  • DOI: https://doi.org/10.1007/s00259-015-3116-4

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