Azedra (iobenguane I 131) / Lantheus - LARVOL DELTA

Potentially fatal crisis after 177Lu-DOTATATE therapy for paraganglioma: a case report with review of literature. (PubMed, Endocr J) - "At the age of 49, he received 131I-MIBG therapy for the recurrence of pheochromocytoma with bone metastasis. In conclusion, while 177Lu-DOTATATE therapy is generally considered safe, our findings underscore the potential risks of fatal crisis after therapy. Careful monitoring of patients with PPGL should be performed after treatment."

Journal • Cardiovascular • Endocrine Cancer • Hematological Disorders • Musculoskeletal Pain • Neuroendocrine Tumor • Oncology • Pain • Solid Tumor • SSTR

Dosimetry-Guided [131I]MIBG Therapy in a Hemodialysis-Dependent Paraganglioma Patient. (PubMed, J Nucl Med) - " Dosimetry-guided treatment with [131I]MIBG in patients requiring hemodialysis is feasible. With appropriate dose reduction, the treatment can be effective with limited side effects."

Journal • Endocrine Cancer • Nephrology • Oncology • Renal Disease • Solid Tumor

Release of HMGB1 from human-derived cancer and normal cells by internal targeted radiotherapy with 131I-meta-iodobenzylguanidine. (PubMed, J Radiat Res) - "HMGB1 was released from neuroblastoma cells but not from normal cells after 131I-MIBG administration. A combination of 131I-MIBG and immunotherapy may be feasible."

Journal • Neuroblastoma • Oncology • Solid Tumor • HMGB1

Semiquantitative 131I MIBG Scintigraphy Predicts Intraoperative Blood Pressure Fluctuation in Patients Undergoing Surgery for Pheochromocytoma and Paraganglioma. (PubMed, Clin Nucl Med) - "Preoperative 131I MIBG scintigraphy is associated with intraoperative BP fluctuation in patients with PPGL. Metanephrine, maximum preoperative blood pressure, and 131I MIBG scintigraphy can predict intraoperative BP fluctuation independently. Personalized preoperative management can be offered to patients based on these assessments."

Journal • Endocrine Cancer • Oncology • Solid Tumor

Tumor sink effect of [18F]MFBG in patients with pheochromocytoma and paraganglioma (SNMMI 2025) - "Meanwhile, [131I]MIBG is approved for radionuclide therapy of metastatic PPGL... The SUVmax and SUVmean of liver and submandibular gland in patients with high tumor burden were significantly lower than that in patients with moderate or low tumor burden (SUVmax of liver [median (IQR)], 4.20 [3.51, 5.02] vs. 5.03 [4.40, 6.03] vs. 5.74 [4.96, 6.63], P<0.001; SUVmean of liver, 2.93 [2.47, 3.79] vs."

Clinical • Endocrine Cancer • Oncology • Solid Tumor

Simplified Dosimetry Using Compartmental Modeling of 124I-MIBG PET for 131I-MIBG Therapy in Neuroblastoma (SNMMI 2025) - "The mono-exponential fit of blood activity measured at the two time points provides a general trend of blood activity changes, although the imaging data are limited. The TACs generated by the proposed compartmental modeling approach using the two-point activities can approximate the reference standard TACs derived from the bi-exponential fitting method better than the mono-exponential method for certain organs and tumors and yield TIA values closer to the reference. Among the organs and tumors of the five subjects, the proposed method resulted in a relative error of 13.4%±12.8% and a relative root mean square error (RMSE) of 19.4%."

Neuroblastoma • Oncology • Solid Tumor

Tumor sink effect of [18F]MFBG in patients with pheochromocytoma and paraganglioma (SNMMI 2025) - "Meanwhile, [131I]MIBG is approved for radionuclide therapy of metastatic PPGL... The SUVmax and SUVmean of liver and submandibular gland in patients with high tumor burden were significantly lower than that in patients with moderate or low tumor burden (SUVmax of liver [median (IQR)], 4.20 [3.51, 5.02] vs. 5.03 [4.40, 6.03] vs. 5.74 [4.96, 6.63], P<0.001; SUVmean of liver, 2.93 [2.47, 3.79] vs."

Clinical • Endocrine Cancer • Oncology • Solid Tumor

Simplified Dosimetry Using Compartmental Modeling of 124I-MIBG PET for 131I-MIBG Therapy in Neuroblastoma (SNMMI 2025) - "The mono-exponential fit of blood activity measured at the two time points provides a general trend of blood activity changes, although the imaging data are limited. The TACs generated by the proposed compartmental modeling approach using the two-point activities can approximate the reference standard TACs derived from the bi-exponential fitting method better than the mono-exponential method for certain organs and tumors and yield TIA values closer to the reference. Among the organs and tumors of the five subjects, the proposed method resulted in a relative error of 13.4%±12.8% and a relative root mean square error (RMSE) of 19.4%."

Neuroblastoma • Oncology • Solid Tumor

Evaluating the Efficacy of 18F-MFBG PET/CT in Differentiating PD from Non-PD Parkinsonism: A Promising Tool (SNMMI 2025) - "This study aims to assess the efficacy of 18F-MFBG PET/CT in differentiating PD from non-PD parkinsonism compared to 131I-MIBG planner scintigraphy... 18F-MFBG PET/CT is an effective imaging modality for assessing myocardial sympathetic innervation, facilitating the differential diagnosis between PD and non-PD parkinsonism. Notably, the SUVmean ratio of myocardial uptake to liver significantly distinguishes the PD group from the non-PD group."

Clinical • Cardiovascular • CNS Disorders • Congestive Heart Failure • Essential Tremor • Heart Failure • Movement Disorders • Multiple System Atrophy • Parkinson's Disease • Progressive Supranuclear Palsy

Preclinical Developments of Novel Theranostic Radiopharmaceutical 3-[76Br/77Br]bromo-pHPG (SNMMI 2025) - "In particular, parahydroxyphenethylguanidine (pHPG) is a suitable norepinephrine-transporter- (NET-) targeted vector with two advantages over the more studied benzylguanidine ([131I]mIBG): faster localization in adrenergic tumor and higher tumor retention...Total and non-specific (blocked with 10 µM desipramine) binding experiments tested cell uptake kinetics from 0.07–100 nM 3-[natBr]Br-pHPG... In vitro 50% effective concentrations (EC50) for SK-N-SH were 7.9 nM (0.48 MBq/mL, n=6) with 95% confidence interval (CI95%) of 5.0 – 14 nM for 3-[77Br]Br-pHPG and 1.29 mM (CI95%= 1.18 – 1.42 mM, n=4) for 3-natBr-pHPG. Similarly, the EC50 for SK-N-MC and SK-N-Be(2)-C were 140 nM (4.6 MBq/mL, CI95%=113 – 149 nM, n=1) and 7.3 nM (1.7 MBq/mL, CI95%=6.3 – undefined nM, n=1), respectively (Figure 2a). Minimal difference was observed between total and non-specific 3-[77Br]Br-pHPG binding to SK-N-SH cells."

Preclinical • Neuroblastoma • Oncology • Solid Tumor

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

Semi-quantitative MIBG Scores in Relapsed/Refractory Neuroblastoma: Prognostic Insights from Post-131I-MIBG Treatment Scans and Impact of SPECT-CT Imaging. (PubMed, Rev Esp Med Nucl Imagen Mol (Engl Ed)) - "Both mCS and SS from post-treatment 131I-MIBG planar scans correlated significantly with overall survival in relapsed/refractory neuroblastoma. Patients with mCS>12 or SS > 23 had poorer survival. SPECT-CT imaging influenced scores for a substantial portion of patients, emphasizing its value alongside planar imaging. Larger, comprehensive studies are warranted to validate these findings and refine prognostic cut-offs. Incorporating SPECT-CT in relevant body regions is recommended for improved disease assessment."

Journal • Neuroblastoma • Oncology • Pediatrics • Solid Tumor

The Biochemical-Imaging Connection: Urinary Noradrenaline and Fluorodeoxyglucose-Positron Emission Tomography in Unresectable or Metastatic Pheochromocytomas and Paragangliomas. (PubMed, Diagnostics (Basel)) - " This retrospective study included 25 patients with unresectable or metastatic PPGLs scheduled for [131I]metaiodobenzylguanidine therapy with FDG-PET data available within 40 days of urine catecholamine measurements...Therefore, FDG-PET may be unnecessary in PPGL patients with low urinary noradrenaline levels. These findings may help optimize imaging strategies for patients with PPGLs."

Journal • Endocrine Cancer • Oncology • Solid Tumor

Late effects in high-risk neuroblastoma survivors who received MIBG therapy. (ASCO 2025) - "In survivors of HRNB, the burden of late toxicities appeared similar in those treated with 131I-MIBG compared to those who were not. This provides critical information for long-term follow-up care and clinical trial design."

Endocrine Disorders • Musculoskeletal Diseases • Neuroblastoma • Oncology • Solid Tumor

Comprehensive Head-to-Head Study between Meta-[211At]astato-benzylguanidine and with Meta-[131I]iodo-benzylguanidine in Pheochromocytoma. (PubMed, Mol Pharm) - "Even at doses 20 times lower than [131I]MIBG, [211At]MABG demonstrated superior antitumor efficacy without inducing substantial weight loss. These findings suggest that [211At]MABG may serve as a promising alternative for treating malignant PCC."

Head-to-Head • Journal • Endocrine Cancer • Neuroendocrine Tumor • Oncology • Solid Tumor • PCNA

Molecular imaging of neuroendocrine tumors: Current applications and future trends. (PubMed, Diagn Interv Imaging) - "In pheochromocytoma, paraganglioma, and neuroblastomas [131I]MIBG can also be considered for imaging...The use of somatostatin receptor antagonists, bombesin receptor 2, C-X-C motif chemokine receptor-4, and glucose-dependent insulinotropic polypeptide receptor agents are currently in development - with all of them requiring further studies to determine their potential utility. This review analyzes the current landscape of NEN imaging and discusses the emerging agents that can potentially contribute to NEN imaging in the future."

Journal • Review • Endocrine Cancer • Neuroblastoma • Neuroendocrine Tumor • Oncology • Solid Tumor • Thyroid Gland Carcinoma • Thyroid Gland Medullary Carcinoma • CXCR4 • GRP-10 • SSTR

MIBG Therapy for Patients With MIBG Avid Tumors (clinicaltrials.gov) - P2 | N=65 | Active, not recruiting | Sponsor: Nationwide Children's Hospital | Trial completion date: Mar 2025 ➔ Dec 2025 | Trial primary completion date: Mar 2025 ➔ Dec 2025

Trial completion date • Trial primary completion date

MIBG With Dinutuximab +/- Vorinostat (clinicaltrials.gov) - P1 | N=45 | Completed | Sponsor: New Approaches to Neuroblastoma Therapy Consortium | Active, not recruiting ➔ Completed

Trial completion • CNS Tumor • Neuroblastoma • Oncology • Solid Tumor • CD34

The Usefulness of 131I-MIBG Myocardial Scintigraphy in a Case of Pure Autonomic Failure - First Report in the Literature. (PubMed, Ann Indian Acad Neurol) - No abstract available

Journal

131I-mIBG therapy in relapsed/refractory neuroblastoma: an old bridge to the future. (PubMed, ESMO Open) - "The 131I-mIBG therapy plus melphalan is confirmed to be effective to reduce/control tumour burden. Further studies are needed to clarify the role and timing of this treatment and to integrate its role in the strategy of CAR-T cells."

Journal • CNS Tumor • Endocrine Disorders • Hematological Disorders • Mucositis • Neuroblastoma • Oncology • Pediatrics • Solid Tumor

Ex vivo-expanded and activated haploidentical natural killer cells infusion before autologous stem cell transplantation in high-risk neuroblastoma: a phase I/II pilot study. (PubMed, Cancer Immunol Immunother) - "After harvesting hematopoietic progenitor cells (HPCs), patients received an intravenous infusion of high-activity iodine-131 (131I)-meta-iodobenzylguanidine (131I-MIBG)...Our study shows that incorporating NK cell infusion before AHSCT as a component of the conditioning regimen for consolidative therapy in pediatric patients with high-risk NB can be safe and well tolerated. IRCT Registration Number: IRCT20140818018842N32."

Journal • P1/2 data • Preclinical • Bone Marrow Transplantation • CNS Tumor • Neuroblastoma • Oncology • Pediatrics • Solid Tumor • Transplantation • NCAM1

Tumor Dose-Response Relationship of [131I]MIBG Therapy in Patients with Neural Crest Tumors by Means of [124I]MIBG PET. (PubMed, J Nucl Med) - "A single 24-h uptake assessment showed predictive value with respect to receiving the target dose. This study demonstrated a clear correlation between tumor-absorbed dose and functional response in [131I]MIBG therapy and proposes a target dose for response at the tumor level."

Journal • Cardiovascular • CNS Tumor • Endocrine Cancer • Hypertension • Neuroblastoma • Oncology • Solid Tumor

Harmonization of practice of release of patients after radiopharmaceutical therapy. (PubMed, J Radiol Prot) - "The study was performed for the following radiopharmaceuticals: 177Lu-PSMA-617, 177Lu-DOTATATE, Na131I, 131I-mIBG, 153Sm-oxabifor. Based on results, it is recommended to follow the approach based on the radioactive decay of radionuclide and dose constrain to members of the public in contact with patient of 1 mSv per one radiopharmaceutical administration and keep patient in the nuclear medicine department after radiopharmaceutical administration for at least 4-6 hours. Patient release criteria defined according to that approach comply with patient release criteria operated in different countries and allow maintaining radiation safety of the public."

Harmonization • Journal

Late nephrotoxicity of peptide receptor radionuclide therapy (PRRT) and impact of selected factors – A single centre cohort study (ENETS 2025) - "AIM(S) To evaluate the nephrotoxicity treatment with 90Y-DOTATATE and tandem therapy 90Y-DOTATATE+177Lu-DOTATATE in patients with neuroendocrine tumours (NETs) including the impact of selected factors that can potentiate kidney damage, as: age, 131IMIBG therapy, chemotherapy, diabetes, arterial hypertension, number of CT scans. CONCLUSION PRRT is an effective therapy, but during the qualification process, it is important to take into account kidney function and after its completion, patients require lifelong monitoring of kidney function. It is necessary to seek factors that may worsen radioisotope-induced kidney damage."

Clinical • Cardiovascular • Diabetes • Diabetic Nephropathy • Endocrine Cancer • Metabolic Disorders • Nephrology • Neuroendocrine Tumor • Oncology • Pulmonary Arterial Hypertension • Renal Disease • Solid Tumor

Urinary Dopamine Levels Can Predict the Avidity of Post-Therapy [131I]MIBG Scintigraphy in Unresectable or Metastatic Pheochromocytomas and Paragangliomas: A Preliminary Clinical Study. (PubMed, Pharmaceuticals (Basel)) - " Age and urinary dopamine levels may predict non-avid lesions in unresectable/metastatic PPGLs, aiding treatment decisions for [131I]MIBG therapy. This article is a revised and expanded version of a paper entitled "Urine dopamine level and age can predict non-avid lesion on scintigraphy after I-131 MIBG treatment for unresectable/metastatic PPGL", which was presented at SNMMI 2024, Toronto, from 8 June to 11 June 2024."

Journal • CNS Tumor • Endocrine Cancer • Neuroendocrine Tumor • Oncology • Solid Tumor