PT  - JOURNAL ARTICLE
AU  - David L. Bushnell
AU  - Kellie L. Bodeker
AU  - Thomas M. O’Dorisio
AU  - Mark T. Madsen
AU  - Yusuf Menda
AU  - Stephen Graves
AU  - Gideon K.D. Zamba
AU  - M. Sue O’Dorisio
TI  - Addition of <sup>131</sup>I-MIBG to PRRT (<sup>90</sup>Y-DOTATOC) for Personalized Treatment of Selected Patients with Neuroendocrine Tumors
AID  - 10.2967/jnumed.120.254987
DP  - 2021 Sep 01
TA  - Journal of Nuclear Medicine
PG  - 1274--1277
VI  - 62
IP  - 9
4099  - http://jnm.snmjournals.org/content/62/9/1274.short
4100  - http://jnm.snmjournals.org/content/62/9/1274.full
SO  - J Nucl Med2021 Sep 01; 62
AB  - Peptide receptor radionuclide therapy (PRRT) is an effective treatment for metastatic neuroendocrine tumors. Delivering a sufficient tumor radiation dose remains challenging because of critical-organ dose limitations. Adding 131I-metaiodobenzylguanidine (131I-MIBG) to PRRT may be advantageous in this regard. Methods: A phase 1 clinical trial was initiated for patients with nonoperable progressive neuroendocrine tumors using a combination of 90Y-DOTATOC plus 131I-MIBG. Treatment cohorts were defined by radiation dose limits to the kidneys and the bone marrow. Subject-specific dosimetry was used to determine the administered activity levels. Results: The first cohort treated subjects to a dose limit of 1,900 cGy to the kidneys and 150 cGy to the marrow. No dose-limiting toxicities were observed. Tumor dosimetry estimates demonstrated an expected dose increase of 34%–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.