Azedra (iobenguane I 131) / Lantheus - LARVOL DELTA

Phase I Study of 131I-Metaiodobenzylguanidine With Dinutuximab ± Vorinostat for Patients With Relapsed or Refractory Neuroblastoma: A New Approaches to Neuroblastoma Therapy Trial. (PubMed, J Clin Oncol) - "MIBG combined with dinutuximab was well tolerated with encouraging antitumor activity. Vorinostat added to this combination may augment responses in this heavily pretreated patient population."

Journal • P1 data • Fatigue • Neuroblastoma • Oncology • Pneumonia • Solid Tumor

Response-adapted consolidation therapy strategy for patients with metastatic high-risk neuroblastoma: Results of the SMC NB-2014 study. (PubMed, Pediatr Blood Cancer) - "Our results suggest that response-adaptive consolidation therapy based on chemotherapy response at metastatic sites facilitates better treatment tailoring, and appears promising for patients with metastatic high-risk neuroblastoma."

Journal • Metastases • Bone Marrow Transplantation • CNS Tumor • Neuroblastoma • Oncology • Solid Tumor • Transplantation

A Phase III Study of 131I-Metaiodobenzylguanidine (131I-MIBG) or Lorlatinib Added to Intensive Therapy for Children with Newly Diagnosed High-Risk Neuroblastoma (ANBL1531) (ASTRO 2026) - No abstract available

Clinical • P3 data • Neuroblastoma • Oncology • Solid Tumor

NANT 2021-02: Randomized MIBG With Vorinostat/Dinutuximab/Vorinostat + Dinutuximab (clinicaltrials.gov) - P2 | N=118 | Not yet recruiting | Sponsor: New Approaches to Neuroblastoma Therapy Consortium | Trial completion date: Jul 2031 ➔ Dec 2031 | Initiation date: Jul 2026 ➔ Dec 2026 | Trial primary completion date: Jul 2030 ➔ Dec 2030

Trial completion date • Trial initiation date • Trial primary completion date • Neuroblastoma • Oncology • Solid Tumor

Current Applications of Molecular Imaging in Adrenal Imaging. (PubMed, Magn Reson Imaging Clin N Am) - "Targeted radiopharmaceutical therapies, 131I-MIBG and 177Lu-DOTATATE (Lutathera), and newer theranostic agents can provide personalized treatment plans for patients. This review discusses molecular imaging based on adrenal tumor biology, receptor expression, and genetic mutations, the imaging characteristics of common adrenal lesions, and current and future therapeutic treatments."

Journal • Review • Adrenal Cortex Carcinoma • Oncology • Solid Tumor

Neuroblastoma imaging: From MIBG to advanced PET tracers. (PubMed, Semin Nucl Med) - "Furthermore, MIBG serves as a theranostic agent, enabling targeted radionuclide therapy with 131I-MIBG in patients with relapsed or refractory disease...This review provides a comprehensive overview of contemporary neuroblastoma imaging, tracing the transition from MIBG-based scintigraphy to advanced PET tracers and emerging theranostic approaches. Understanding the complementary roles of these imaging modalities is essential for optimizing patient management and improving outcomes in children with this complex and heterogeneous malignancy."

Journal • Review • Neuroblastoma • Oncology • Pediatrics • Solid Tumor • SSTR

First-in-human, open-label, single-arm phase 1 study of [211At] meta-astatobenzylguanidine in patients with pheochromocytoma or paraganglioma. (PubMed, Clin Cancer Res) - "A single dose of 211At-MABG at 2.1 MBq/kg was well tolerated and demonstrated predictable pharmacokinetics. Preliminary antitumor activity was observed, including one partial response during the 12-week period. These findings establish the clinical feasibility of ²¹¹At-MABG and provide a translational foundation for multi-dose, dose-escalation, and biomarker-stratified trials."

First-in-human • Journal • P1 data • Oncology • Solid Tumor

Molecular Imaging and Radioligand Therapies in Pheochromocytomas and Paragangliomas. (PubMed, Endocr Relat Cancer) - "High-specific-activity 131I-MIBG has demonstrated durable disease control, symptomatic improvement, and favorable safety in multicenter studies, leading to FDA approval for metastatic PPGL, although currently not commercially available. More recently, peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE has shown disease control rates of 80-100% in prospective and retrospective trials, with outcomes enhanced by standardized dosing strategies. Ongoing studies are evaluating PRRT in genetically defined subgroups and exploring synergistic combinations, including radiosensitizing approaches."

Journal • Neuroendocrine Tumor • Oncology • Solid Tumor • SSTR

Systemic Management of Adrenal Malignancies: Adrenocortical carcinoma and pheochromocytoma/paraganglioma. (PubMed, Endocr Connect) - "When rapid tumor control is needed, etoposide, doxorubicin, cisplatin, and mitotane remains the standard first-line regimen...Cyclophosphamide, vincristine, and dacarbazine may be considered for aggressive disease, rapid growth, or high tumor burden. Targeted and radiopharmaceutical approaches have expanded options, including high-specific-activity 131I-iobenguane for MIBG-avid tumors, 177Lu-DOTATATE for somatostatin receptor-positive disease, antiangiogenic tyrosine kinase inhibitors, and HIF-2α inhibition with belzutifan in selected molecular contexts. For both ACC and PPGL, controlling steroid or catecholamine excess is crucial, because endocrine complications affect treatment tolerance and outcomes. Future progress requires robust biomarkers, rational treatment sequencing, and trials using disease-specific endpoints beyond radiographic response and integrating patient-centered endocrine, molecular, and overall clinical measures of benefit."

IO biomarker • Journal • Adrenal Cortex Carcinoma • Endocrine Cancer • Genito-urinary Cancer • Oncology • Solid Tumor • EPAS1 • SSTR

Ultrasound-guided, nursing-led, phase-based swallowing rehabilitation in elderly patients with MIBG-positive medullary thyroid carcinoma following 131I-MIBG therapy. (PubMed, Front Med (Lausanne)) - "Participation in ultrasound-guided, nursing-led, phase-based swallowing rehabilitation was associated with significant improvements in swallowing function, muscle performance, nutritional status, and quality of life in elderly patients with MIBG-positive MTC after 131I-MIBG therapy. This approach appears safe, feasible, and scalable for geriatric oncology rehabilitation."

Journal • Gastrointestinal Disorder • Infectious Disease • Oncology • Otorhinolaryngology • Pneumonia • Respiratory Diseases • Solid Tumor • Thyroid Gland Carcinoma • Thyroid Gland Medullary Carcinoma

Application of 131I-MIBG imaging in assessing renal sympathetic overdrive in heart failure with preserved ejection fraction (HFpEF). (PubMed, Am J Transl Res) - "131I-MIBG imaging successfully quantifies renal-cardiac sympathetic crosstalk in HFpEF. The markedly elevated K/M ratios demonstrate that renal sympathetic overactivity is a core driver of hemodynamic congestion in these patients. Clinically, this technique may serve as a powerful non-invasive biomarker to identify candidates for sympatho-inhibitory therapies and provides a precise tool for monitoring therapeutic efficacy in HFpEF management."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Pulmonary Disease

Imaging of Adrenal and Extra-Adrenal Paraganglioma. (PubMed, Semin Ultrasound CT MR) - "Contemporary consensus places somatostatin‑receptor analogues (SSAs) such as 68Ga-DOTATATE and 64Cu-DOTATATE at the center of head‑and‑neck paraganglioma (HNPGL), SDHx‑mutated disease, sporadic or hereditary HNPGLs and metastatic PPGLs, while 18F‑FDOPA is increasingly favored for adrenal pheochromocytoma (PCC); and 18F‑FDG complements both by detecting aggressive biology. MIBG now is only considered for inoperable or metastatic PPGLs under consideration for 131I‑MIBG therapy."

Journal • Review • Endocrine Cancer • Oncology • Solid Tumor • SSTR

Optimizing 131I-mIBG Dosimetry: Validation of Simplified Time-Point and Segmentation Approaches. (PubMed, Nucl Med Mol Imaging) - "The 4 mL peak sphere overestimated absorbed doses by 69% versus whole-organ delineation (0.61 vs. 0.36 mGy/MBq, p < 0.001), and homogeneous spheres underestimated by 8% (0.33 vs. 0.36 mGy/MBq, p = 0.046). Clinically feasible 131I-mIBG dosimetry can be achieved through: (1) dual 24 h/48 h imaging (< 6% mean bias), (2) single 48 h Hänscheid method (< 6% mean bias), and (3) homogeneous sphere liver segmentation (< 8% mean difference from reference)."

Journal • Pediatrics

Triple-tracer Functional Imaging in a Rare Case of Thyroid Paraganglioma. (PubMed, Clin Nucl Med) - "A 79-year-old woman with suspected choroidal lesion underwent 18F-FDG PET/CT, which revealed a non-FDG-avid right thyroid lobe incidentaloma (4.8 cm in largest dimension) that was cold on 99mTc-thyroid scan, showed intense SSTR expression on 68Ga-DOTATATE PET/CT, and MIBG avidity on 131I-MIBG scan, thereby proving it to be of neural crest origin. Fine needle aspiration biopsy (FNAB) with immunohistochemistry was positive for GATA3 and synaptophysin and negative for CK7, PAX8, TTF1, and calcitonin, establishing the diagnosis of thyroid paraganglioma. Even though rare, the diagnosis of paraganglioma should be considered in SSTR and MIBG-avid thyroid nodules, as seen in this case."

Journal • Oncology • Solid Tumor • GATA3 • NKX2-1 • PAX8 • SSTR • SYP

A pilot study combining primary busulfan-based haploidentical stem cell transplantation with GD2 antibody to treat high-risk neuroblastoma. (PubMed, Bone Marrow Transplant) - "We report administration of a conditioning regimen combining myeloablative busulfan/melphalan anti-tumor therapy with the immunological advantages of haplo-SCT and GD2-directed antibody-based immunotherapy with dinutuximab beta (DB)...Prior to busulfan, melphalan, fludarabine and antithymocyte globulin conditioning followed by T/B-cell-depleted haplo-SCT and 6 DB cycles, 2 patients received [131I]MIBG therapy...Early results suggest a survival benefit for these pediatric patient subgroups at very high risk. Confirmation in a larger controlled trial is warranted."

IO biomarker • Journal • Neuroblastoma • Oncology • Pediatrics • Solid Tumor • Transplantation

Structural Optimization of NET-Targeted Agents: ortho-Radioiodinated Phenoxyalkylguanidine Achieves Enhanced Tumor Retention and Radiotherapeutic Efficacy. (PubMed, J Med Chem) - "At half the dose, ortho-131I-PhOG exerted comparable tumor growth inhibition (TGI = 92.9%) to 10.0 MBq [131I]mIBG, with prolonged survival and no obvious toxicity. These results underscore that the strategic incorporation of a phenoxyalkyl linker improves the pharmacokinetic and therapeutic profiles of NET-targeted radiopharmaceuticals, positioning ortho-131I-PhOG as a promising candidate for neuroendocrine tumor theranostics."

Journal • Neuroendocrine Tumor • Oncology • Solid Tumor

Early treatment response assessment in pediatric neuroblastoma with 68Ga-DOTANOC PET/CT: Superior concordance with clinical outcome (SNMMI 2026) - "Both the pre and post chemotherapy 68Ga-DOTANOC PET MIP and 131I-mIBG planar were compared to look for response assessment... DOTANOC PET/CT demonstrates superior sensitivity to early therapeutic change, especially in initially mIBG-occult marrow metastases, and aligns more faithfully with short-term clinical remission. Baseline marrow infiltration and male sex emerged as adverse predictors, suggesting intensified or alternative approaches for these subsets. Thus, DOTANOC-based response criteria may merit incorporation into future response-adapted protocols."

Clinical • Clinical data • Discordant • Neuroblastoma • Pediatrics • Solid Tumor

Bioequivalence and dosimetry estimates of GD2-targeting Dinutuximab-Beta labelled with indium-111, lutetium-177, and actinium-225 (SNMMI 2026) - "Radionuclide therapy with [131I]MIBG is an established treatment but clinical outcomes are heterogeneous. DOTA-conjugated Dinutuximab-Beta can be successfully labelled with alpha- and beta-emitting radionuclides, 225Ac and 177Lu, which allows its investigation as a molecular radiotherapy approach for the treatment of high-risk neuroblastoma. 111In-DB can be utilised as a tool to predict the in vivo biodistribution of 225Ac-DB and 177Lu-DB, with potential for translational SPECT imaging and dosimetry assessments. The limitations to this approach derive from the gradual accumulation of 225Ac in the bone and assumptions on daughter translocation."

Neuroblastoma • Solid Tumor

A Novel Approach to Radiolabeling mIBG Analogs Through Synthesis of Asymmetric Guanidines (SNMMI 2026) - "Info Purpose/Background: Only about 33% of neuroblastoma patients respond to [131I]mIBG therapy due to insufficient expression of norepinephrine transporter (NET) or retention in the tumor.[1] Moving from a benzyl guanidine to a phenyethyl guanidine offers improved uptake and retention via VMAT2 activity and vesicular trapping, but adding larger halogens on the phenyl ring for therapy reduces the rate of uptake.[2] Modifications of mIBG to date have focused on changes to the benzyl portion of the structure... A method for the development of a novel set of iodinated analogs of mIBG has been prepared. This opens the door for further research into improved agents for the diagnosis and treatment of neuroblastoma and related tumors, such as pheochromocytoma and paraganglioma. Future studies in tumor models are planned to evaluate these agents further now that a means to rapidly access carbon-11 radiolabeled analogs has been developed."

Neuroblastoma • Solid Tumor

Sustainable Radiochemical Analysis of ¹³¹I-mIBG Using Sodium Citrate Buffer: A Green Chemistry Approach (SNMMI 2026) - "From the result it is concluded that 0.1M sod. citrate buffer can be use for RCP of 131I-mIBG. This method demonstrates that a non-hazardous buffer system can provide clear resolution of ¹³¹I-mIBG from free iodide and other radiochemical impurities."

Neuroblastoma • Neuroendocrine Tumor • Solid Tumor

Early treatment response assessment in pediatric neuroblastoma with 68Ga-DOTANOC PET/CT: Superior concordance with clinical outcome (SNMMI 2026) - "Both the pre and post chemotherapy 68Ga-DOTANOC PET MIP and 131I-mIBG planar were compared to look for response assessment... DOTANOC PET/CT demonstrates superior sensitivity to early therapeutic change, especially in initially mIBG-occult marrow metastases, and aligns more faithfully with short-term clinical remission. Baseline marrow infiltration and male sex emerged as adverse predictors, suggesting intensified or alternative approaches for these subsets. Thus, DOTANOC-based response criteria may merit incorporation into future response-adapted protocols."

Clinical • Clinical data • Discordant • Neuroblastoma • Pediatrics • Solid Tumor

Aqueous-phase automated radiosynthesis of [211At]MABG using boronic acid–mediated astatination and cartridge purification (SNMMI 2026) - "Info Purpose/Background: A previous head-to-head study demonstrated that [211At]MABG exhibits superior antitumor efficacy compared with [131I]MIBG in malignant neuroendocrine tumors... In this study, a radiosynthesis protocol was successfully established for [211At]MABG. Potassium iodide enabled efficient At-211 labeling in the aqueous phase and cartridge-based purification simplified the overall workflow. This approach has the potential to support reproducible, GMP-compliant production of [211At]MABG through automated synthesis for clinical application."

Neuroendocrine Tumor • Solid Tumor

Comparison of 68 Ga DOTANOC PET/CT with 131 I-MIBG SPECT/CT in patients with suspected pheochromocytoma: Insights from a tertiary center experience (SNMMI 2026) - "68Ga-DOTANOC PET/CT demonstrates superior overall sensitivity for the diagnosis of PPGLs, particularly for paragangliomas and head and neck paragangliomas, and may detect a greater extent of metastatic disease. In contrast, 131I-MIBG SPECT/CT shows higher sensitivity for the diagnosis of pheochromocytoma. The specificity of both modalities was comparable in this study, likely due to the high pretest probability of disease in the selected patient population."

Clinical • Neuroendocrine Tumor • Solid Tumor

Sustainable Radiochemical Analysis of ¹³¹I-mIBG Using Sodium Citrate Buffer: A Green Chemistry Approach (SNMMI 2026) - "From the result it is concluded that 0.1M sod. citrate buffer can be use for RCP of 131I-mIBG. This method demonstrates that a non-hazardous buffer system can provide clear resolution of ¹³¹I-mIBG from free iodide and other radiochemical impurities."

Neuroblastoma • Neuroendocrine Tumor • Solid Tumor

Early treatment response assessment in pediatric neuroblastoma with 68Ga-DOTANOC PET/CT: Superior concordance with clinical outcome (SNMMI 2026) - "Both the pre and post chemotherapy 68Ga-DOTANOC PET MIP and 131I-mIBG planar were compared to look for response assessment... DOTANOC PET/CT demonstrates superior sensitivity to early therapeutic change, especially in initially mIBG-occult marrow metastases, and aligns more faithfully with short-term clinical remission. Baseline marrow infiltration and male sex emerged as adverse predictors, suggesting intensified or alternative approaches for these subsets. Thus, DOTANOC-based response criteria may merit incorporation into future response-adapted protocols."

Clinical • Clinical data • Discordant • Neuroblastoma • Pediatrics • Solid Tumor