Universität zu Köln

Kraal, K. C. J. M., Bleeker, G. M., van Eck-Smit, B. L. F., van Eijkelenburg, N. K. A., Berthold, F., van Noesel, M. M., Caron, H. N. and Tytgat, G. A. M. (2017). Feasibility, toxicity and response of upfront metaiodobenzylguanidine therapy therapy followed by German Pediatric Oncology Group Neuroblastoma 2004 protocol in newly diagnosed stage 4 neuroblastoma patients. Eur. J. Cancer, 76. S. 188 - 197. OXFORD: ELSEVIER SCI LTD. ISSN 1879-0852

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Abstract

Aim of the study: Radiolabelled meta-iodobenzylguanidine (MIBG) is an effective option in treatment of neuroblastoma (NBL) tumours. We studied feasibility, toxicity and efficacy of upfront 1311-MIBG and induction treatment in stage 4 NBL patients. Patients and methods: Retrospective, multi-centre (AMC and EMC) pilot regimen (1/1/2005 2011). Newly diagnosed stage 4 NBL patients, were treated with 2 courses of 1311-MIBG, GP01-1 2004 NBL protocol, myeloablative therapy (MAT) and autologous stem cell rescue (ASCT). 1311-MIBG was administered in a fixed dose. Response rate (RR) was defined as complete remission, very good partial response and partial response. Results: Thirty-two patients, (median age [range] 2.9 [0-11.4] years), 21 received 1311-MIBG therapy, 11 did not because of: MIBG non-avid (N = 5) and poor clinical condition (N = 6). In 95% of eligible patients I-131-MIBG treatment was feasible within 2 weeks from diagnosis. Interval between chemotherapy courses was 25 days (I-131-MIBG group) versus 22 days (chemotherapy group). No stem cell support was needed after I-131-MIBG therapy. Stem cell harvest in both groups was feasible, neutrophil recovery was comparable, but platelet recovery post MAT, ASCT was slower for I-131-MIBG-treated patients. RR post I-131-MIBG was 38%, post MAT + ASCT was 71% (I-131-MIBG group), 36% (chemotherapy group) and overall 59%. Conclusions: Induction therapy with I-131-MIBG before the HR GPOH NB 2004 protocol is feasible, tolerable and effective in newly diagnosed stage 4 NBL patients. I-131-MIBG upfront therapy induces early responses. (C) 2017 Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kraal, K. C. J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bleeker, G. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Eck-Smit, B. L. F. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Eijkelenburg, N. K. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Berthold, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Noesel, M. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Caron, H. N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tytgat, G. A. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-232339
DOI:	10.1016/j.ejca.2016.12.013
Journal or Publication Title:	Eur. J. Cancer
Volume:	76
Page Range:	S. 188 - 197
Date:	2017
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1879-0852
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HIGH-RISK NEUROBLASTOMA; BONE-MARROW-TRANSPLANTATION; REFRACTORY NEUROBLASTOMA; IODINE-131-METAIODOBENZYLGUANIDINE THERAPY; INTERNATIONAL CRITERIA; NEURO-BLASTOMA; SCORING SYSTEM; CHEMOTHERAPY; I-131-METAIODOBENZYLGUANIDINE; TRIAL Multiple languages Oncology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23233