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OtherBrief Communication
Open Access

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 A Graves, M. Sue O'Dorisio and Gideon K. D. Zamba
Journal of Nuclear Medicine January 2021, jnumed.120.254987; DOI: https://doi.org/10.2967/jnumed.120.254987
David L. Bushnell
1 Iowa City Veterans Administration Hospital, United States;
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Kellie L. Bodeker
2 University of Iowa Hospital and Clinics Department of Radiology, Divisions of Nuclear Medicine and Radiation Oncology, United States;
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Thomas M. O'Dorisio
3 University of Iowa Hospital and Clinics Department of Internal Medicine, Division of Endocrinology, United States;
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Mark T. Madsen
4 University of Iowa Hospital and Clinics Department of Radiology, Division of Nuclear Medicine, United States;
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Yusuf Menda
5 University of Iowa Hospital and Clinics Department of Radiology, Divisions of Nuclear Medicine and Radiation Oncology, and Iowa City VA, United States;
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Stephen A Graves
2 University of Iowa Hospital and Clinics Department of Radiology, Divisions of Nuclear Medicine and Radiation Oncology, United States;
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  • ORCID record for Stephen A Graves
M. Sue O'Dorisio
6 University of Iowa Hospital and Clinics, Department of Pediatrics;
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Gideon K. D. Zamba
7 University of Iowa Hospital and Clinics Department of Bio-statistics
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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.

  • Neuroendocrine
  • Oncology: GI
  • Radionuclide Therapy
  • DOTATOC
  • MIBG
  • dosimetry

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  • Immediate Open Access: Creative Commons Attribution 4.0 International License (CC BY) allows users to share and adapt with attribution, excluding materials credited to previous publications. License: https://creativecommons.org/licenses/by/4.0/. Details: https://jnm.snmjournals.org/page/permissions.

  • Copyright © 2021 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

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Journal of Nuclear Medicine: 62 (3)
Journal of Nuclear Medicine
Vol. 62, Issue 3
March 1, 2021
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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 A Graves, M. Sue O'Dorisio, Gideon K. D. Zamba
Journal of Nuclear Medicine Jan 2021, jnumed.120.254987; 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
David L. Bushnell, Kellie L. Bodeker, Thomas M. O'Dorisio, Mark T. Madsen, Yusuf Menda, Stephen A Graves, M. Sue O'Dorisio, Gideon K. D. Zamba
Journal of Nuclear Medicine Jan 2021, jnumed.120.254987; DOI: 10.2967/jnumed.120.254987
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Keywords

  • Neuroendocrine
  • Oncology: GI
  • Radionuclide Therapy
  • DOTATOC
  • MIBG
  • dosimetry
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