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Long-term outcomes of 131.sup.Iodine mIBG therapy in metastatic gastrointestinal pancreatic neuroendocrine tumours: single administration predicts non-responders

Byline: Nicola Mulholland (1), Riddhika Chakravartty (1), Lindsey Devlin (1), Eleni Kalogianni (1), Ben Corcoran (1), Gillian Vivian (1) Keywords: Metaiodobenzylguanidine; I131 mIBG; Neuroendocrine tumours; Carcinoid; Radionuclide therapy; Risk stratification Background [.sup.131]Iodine (I131)-metai... Full description

Journal Title: European journal of nuclear medicine and molecular imaging 2015-12-01, Vol.42 (13)
Main Author: Mulholland, Nicola
Other Authors: Chakravartty, Riddhika , Devlin, Lindsey , Kalogianni, Eleni , Corcoran, Ben , Vivian, Gillian
Format: Electronic Article Electronic Article
Language: English
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Publisher: Springer
ID: ISSN: 1619-7070
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recordid: cdi_gale_infotracacademiconefile_A432905763
title: Long-term outcomes of 131.sup.Iodine mIBG therapy in metastatic gastrointestinal pancreatic neuroendocrine tumours: single administration predicts non-responders
format: Article
creator:
  • Mulholland, Nicola
  • Chakravartty, Riddhika
  • Devlin, Lindsey
  • Kalogianni, Eleni
  • Corcoran, Ben
  • Vivian, Gillian
subjects:
  • Metastasis
  • Prognosis
ispartof: European journal of nuclear medicine and molecular imaging, 2015-12-01, Vol.42 (13)
description: Byline: Nicola Mulholland (1), Riddhika Chakravartty (1), Lindsey Devlin (1), Eleni Kalogianni (1), Ben Corcoran (1), Gillian Vivian (1) Keywords: Metaiodobenzylguanidine; I131 mIBG; Neuroendocrine tumours; Carcinoid; Radionuclide therapy; Risk stratification Background [.sup.131]Iodine (I131)-metaiodobenzylguanidine (mIBG) is a radionuclide-based treatment option for metastatic gastrointestinal-pancreatic neuroendocrine tumours (GEP NET). This study aimed at identifying prognostic indicators of long-term outcome based on initial evaluation following a first mIBG treatment (7400 MBq) in a patient cohort with such tumours, with a secondary aim of evaluating progression-free survival (PFS) and overall survival (OS) following mIBG therapy. Methods Retrospective review of the hospital records was performed to identify a cohort of 38 adult patients who underwent 131.sup.Iodine-mIBG therapy over a 9-year period for metastatic GEP NETs and neuroendocrine tumours with an unknown primary. Treatment response was evaluated based on radiological criteria (RECIST1.1), biochemical markers [serum Chromogranin A (CgA)/urinary 5HIAA] and symptomatic response at clinical follow-up, all evaluated at 3--6 months from first mIBG treatment. Progression-free survival (PFS) and overall survival (OS) from the first mIBG treatment were recorded. Results At 3--6 months following a single mIBG therapy, 75 %, 67 %, and 63 % of patients showed either a partial response (PR) or stable disease (SD) on radiological, biochemical, and symptomatic criteria, respectively. Complete response (CR) was not seen in any patient. OS from the date of diagnosis and from the first therapy was 8 years +/-1.1 (95 % CI 5.7 to 10.2 years) and 4 years+/-0.69 (95 % CI 2.6--5.3 years), respectively. Twenty-nine percent of patients were alive at 10 years. Significant survival advantage was seen in patients with SD/PR as compared to those who had progressive disease (PD) for each of these three criteria. Conclusion Biochemical, radiological (RECIST 1.1) and symptomatic assessment of disease status at 3 to 6 months after first I131-mIBG therapy stratifies patients with a poor prognosis. This can be used to identify patients who may benefit from alternative strategies of treatment. Author Affiliation: (1) Department of Nuclear Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS, UK Article History: Registration Date: 11/06/2015 Received Date: 20/02/2015 Accepted Date: 10/06/2015 Online Date: 05/07/20
language: eng
source:
identifier: ISSN: 1619-7070
fulltext: no_fulltext
issn:
  • 1619-7070
  • 1619-7089
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titleLong-term outcomes of 131.sup.Iodine mIBG therapy in metastatic gastrointestinal pancreatic neuroendocrine tumours: single administration predicts non-responders
creatorMulholland, Nicola ; Chakravartty, Riddhika ; Devlin, Lindsey ; Kalogianni, Eleni ; Corcoran, Ben ; Vivian, Gillian
creatorcontribMulholland, Nicola ; Chakravartty, Riddhika ; Devlin, Lindsey ; Kalogianni, Eleni ; Corcoran, Ben ; Vivian, Gillian
descriptionByline: Nicola Mulholland (1), Riddhika Chakravartty (1), Lindsey Devlin (1), Eleni Kalogianni (1), Ben Corcoran (1), Gillian Vivian (1) Keywords: Metaiodobenzylguanidine; I131 mIBG; Neuroendocrine tumours; Carcinoid; Radionuclide therapy; Risk stratification Background [.sup.131]Iodine (I131)-metaiodobenzylguanidine (mIBG) is a radionuclide-based treatment option for metastatic gastrointestinal-pancreatic neuroendocrine tumours (GEP NET). This study aimed at identifying prognostic indicators of long-term outcome based on initial evaluation following a first mIBG treatment (7400 MBq) in a patient cohort with such tumours, with a secondary aim of evaluating progression-free survival (PFS) and overall survival (OS) following mIBG therapy. Methods Retrospective review of the hospital records was performed to identify a cohort of 38 adult patients who underwent 131.sup.Iodine-mIBG therapy over a 9-year period for metastatic GEP NETs and neuroendocrine tumours with an unknown primary. Treatment response was evaluated based on radiological criteria (RECIST1.1), biochemical markers [serum Chromogranin A (CgA)/urinary 5HIAA] and symptomatic response at clinical follow-up, all evaluated at 3--6 months from first mIBG treatment. Progression-free survival (PFS) and overall survival (OS) from the first mIBG treatment were recorded. Results At 3--6 months following a single mIBG therapy, 75 %, 67 %, and 63 % of patients showed either a partial response (PR) or stable disease (SD) on radiological, biochemical, and symptomatic criteria, respectively. Complete response (CR) was not seen in any patient. OS from the date of diagnosis and from the first therapy was 8 years +/-1.1 (95 % CI 5.7 to 10.2 years) and 4 years+/-0.69 (95 % CI 2.6--5.3 years), respectively. Twenty-nine percent of patients were alive at 10 years. Significant survival advantage was seen in patients with SD/PR as compared to those who had progressive disease (PD) for each of these three criteria. Conclusion Biochemical, radiological (RECIST 1.1) and symptomatic assessment of disease status at 3 to 6 months after first I131-mIBG therapy stratifies patients with a poor prognosis. This can be used to identify patients who may benefit from alternative strategies of treatment. Author Affiliation: (1) Department of Nuclear Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS, UK Article History: Registration Date: 11/06/2015 Received Date: 20/02/2015 Accepted Date: 10/06/2015 Online Date: 05/07/2015
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descriptionByline: Nicola Mulholland (1), Riddhika Chakravartty (1), Lindsey Devlin (1), Eleni Kalogianni (1), Ben Corcoran (1), Gillian Vivian (1) Keywords: Metaiodobenzylguanidine; I131 mIBG; Neuroendocrine tumours; Carcinoid; Radionuclide therapy; Risk stratification Background [.sup.131]Iodine (I131)-metaiodobenzylguanidine (mIBG) is a radionuclide-based treatment option for metastatic gastrointestinal-pancreatic neuroendocrine tumours (GEP NET). This study aimed at identifying prognostic indicators of long-term outcome based on initial evaluation following a first mIBG treatment (7400 MBq) in a patient cohort with such tumours, with a secondary aim of evaluating progression-free survival (PFS) and overall survival (OS) following mIBG therapy. Methods Retrospective review of the hospital records was performed to identify a cohort of 38 adult patients who underwent 131.sup.Iodine-mIBG therapy over a 9-year period for metastatic GEP NETs and neuroendocrine tumours with an unknown primary. Treatment response was evaluated based on radiological criteria (RECIST1.1), biochemical markers [serum Chromogranin A (CgA)/urinary 5HIAA] and symptomatic response at clinical follow-up, all evaluated at 3--6 months from first mIBG treatment. Progression-free survival (PFS) and overall survival (OS) from the first mIBG treatment were recorded. Results At 3--6 months following a single mIBG therapy, 75 %, 67 %, and 63 % of patients showed either a partial response (PR) or stable disease (SD) on radiological, biochemical, and symptomatic criteria, respectively. Complete response (CR) was not seen in any patient. OS from the date of diagnosis and from the first therapy was 8 years +/-1.1 (95 % CI 5.7 to 10.2 years) and 4 years+/-0.69 (95 % CI 2.6--5.3 years), respectively. Twenty-nine percent of patients were alive at 10 years. Significant survival advantage was seen in patients with SD/PR as compared to those who had progressive disease (PD) for each of these three criteria. Conclusion Biochemical, radiological (RECIST 1.1) and symptomatic assessment of disease status at 3 to 6 months after first I131-mIBG therapy stratifies patients with a poor prognosis. This can be used to identify patients who may benefit from alternative strategies of treatment. Author Affiliation: (1) Department of Nuclear Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS, UK Article History: Registration Date: 11/06/2015 Received Date: 20/02/2015 Accepted Date: 10/06/2015 Online Date: 05/07/2015
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abstractByline: Nicola Mulholland (1), Riddhika Chakravartty (1), Lindsey Devlin (1), Eleni Kalogianni (1), Ben Corcoran (1), Gillian Vivian (1) Keywords: Metaiodobenzylguanidine; I131 mIBG; Neuroendocrine tumours; Carcinoid; Radionuclide therapy; Risk stratification Background [.sup.131]Iodine (I131)-metaiodobenzylguanidine (mIBG) is a radionuclide-based treatment option for metastatic gastrointestinal-pancreatic neuroendocrine tumours (GEP NET). This study aimed at identifying prognostic indicators of long-term outcome based on initial evaluation following a first mIBG treatment (7400 MBq) in a patient cohort with such tumours, with a secondary aim of evaluating progression-free survival (PFS) and overall survival (OS) following mIBG therapy. Methods Retrospective review of the hospital records was performed to identify a cohort of 38 adult patients who underwent 131.sup.Iodine-mIBG therapy over a 9-year period for metastatic GEP NETs and neuroendocrine tumours with an unknown primary. Treatment response was evaluated based on radiological criteria (RECIST1.1), biochemical markers [serum Chromogranin A (CgA)/urinary 5HIAA] and symptomatic response at clinical follow-up, all evaluated at 3--6 months from first mIBG treatment. Progression-free survival (PFS) and overall survival (OS) from the first mIBG treatment were recorded. Results At 3--6 months following a single mIBG therapy, 75 %, 67 %, and 63 % of patients showed either a partial response (PR) or stable disease (SD) on radiological, biochemical, and symptomatic criteria, respectively. Complete response (CR) was not seen in any patient. OS from the date of diagnosis and from the first therapy was 8 years +/-1.1 (95 % CI 5.7 to 10.2 years) and 4 years+/-0.69 (95 % CI 2.6--5.3 years), respectively. Twenty-nine percent of patients were alive at 10 years. Significant survival advantage was seen in patients with SD/PR as compared to those who had progressive disease (PD) for each of these three criteria. Conclusion Biochemical, radiological (RECIST 1.1) and symptomatic assessment of disease status at 3 to 6 months after first I131-mIBG therapy stratifies patients with a poor prognosis. This can be used to identify patients who may benefit from alternative strategies of treatment. Author Affiliation: (1) Department of Nuclear Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS, UK Article History: Registration Date: 11/06/2015 Received Date: 20/02/2015 Accepted Date: 10/06/2015 Online Date: 05/07/2015
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