RT Journal Article
SR Electronic
T1 Addition of <sup>131</sup>I-MIBG to PRRT (<sup>90</sup>Y-DOTATOC) for Personalized Treatment of Selected Patients with Neuroendocrine Tumors
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1274
OP 1277
DO 10.2967/jnumed.120.254987
VO 62
IS 9
A1 David L. Bushnell
A1 Kellie L. Bodeker
A1 Thomas M. O’Dorisio
A1 Mark T. Madsen
A1 Yusuf Menda
A1 Stephen Graves
A1 Gideon K.D. Zamba
A1 M. Sue O’Dorisio
YR 2021
UL http://jnm.snmjournals.org/content/62/9/1274.abstract
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.