Abstract
INTRODUCTION: PRRT is an effective treatment for metastatic neuroendocrine tumors (NETs). Delivering sufficient tumor radiation dose remains challenging due to critical organ dose-limitations. Adding 131I MIBG to PRRT may be advantageous in this regard. METHODS: A phase 1 clinical trial was initiated for patients with non-operable progressive NETs using a combination of 90Y DOTATOC plus 131I MIBG. Treatment cohorts were defined by radiation dose limits to kidneys and bone marrow. Subject specific dosimetry was used to determine the administered activity levels. RESULTS: The first cohort treated subjects to 1900 cGy kidneys and 150 cGy marrow. No dose limiting toxicities were observed. Tumor dosimetry estimates demonstrated an expected dose increase of 43-83% 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.
Footnotes
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