High-specific-activity-131I-MIBG versus 177Lu-DOTATATE targeted radionuclide therapy for metastatic pheochromocytoma and paraganglioma

Abhishek Jha, David Taïeb, Jorge A. Carrasquillo, Daniel A. Pryma, Mayank Patel, Corina Millo, Wouter W. de Herder, Jaydira Del Rivero, Joakim Crona, Barry L. Shulkin, Irene Virgolini, Alice P. Chen, Bhagwant R. Mittal, Sandip Basu, Joseph S. Dillon, Thomas A. Hope, Carina Mari Aparici, Andrei H. Iagaru, Rodney J. Hicks, Anca M. AvramJonathan R. Strosberg, Ali Cahid Civelek, Frank I. Lin, Neeta Pandit-Taskar, Karel Pacak*

*Corresponding author for this work

Research output: Contribution to journalReview articleProfessionalpeer-review

21 Citations (Scopus)

Abstract

Targeted radionuclide therapies (TRT) using 131I-metaiodobenzylguanidine (131I-MIBG) and peptide receptor radionuclide therapy (177Lu or 90Y) represent several of the therapeutic options in the management of metastatic/inoperable pheochromocytoma/paraganglioma. Recently, high-specific-activity-131I-MIBG therapy was approved by the FDA and both 177Lu-DOTATATE and 131I-MIBG therapy were recommended by the National Comprehensive Cancer Network guidelines for the treatment of metastatic pheochromocytoma/paraganglioma. However, a clinical dilemma often arises in the selection of TRT, especially when a patient can be treated with either type of therapy based on eligibility by MIBG and somatostatin receptor imaging. To address this problem, we assembled a group of international experts, including oncologists, endocrinologists, and nuclear medicine physicians, with substantial experience in treating neuroendocrine tumors with TRTs to develop consensus and provide expert recommendations and perspectives on how to select between these two therapeutic options for metastatic/inoperable pheochromocytoma/paraganglioma. This article aims to summarize the survival outcomes of the available TRTs; discuss personalized treatment strategies based on functional imaging scans; address practical issues, including regulatory approvals; and compare toxicities and risk factors across treatments. Furthermore, it discusses the emerging TRTs.

Original languageEnglish
Pages (from-to)2989-2995
Number of pages7
JournalClinical Cancer Research
Volume27
Issue number11
DOIs
Publication statusPublished - 1 Jun 2021

Bibliographical note

Funding Information:
This work was supported, in part, by the Intramural Research Program of the NIH, Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant no., Z1AHD008735), and was supported, in part, by the NIH, NCI Center Support grant P30 CA008748.

Funding Information:
J.A. Carrasquillo reports grants from Memorial Sloan Kettering Cancer Center during the conduct of the study. D.A. Pryma reports grants and personal fees from Progenics during the conduct of the study. D.A. Pryma also reports grants and personal fees from Siemens, 511 Pharma, and Fusion Pharma; personal fees from Ipsen and Bayer; and grants from Nordic Nanovector and Lantheus outside the submitted work. W.W. de Herder reports grants from Ipsen outside the submitted work. J. Crona reports personal fees from Novartis and NET Connect during the conduct of the study. J.S. Dillon reports other from Progenics outside the submitted work. T.A. Hope reports research grant from Clovis Oncology, consultant with Curium and ITMa, and advisory board membership with Blue Earth Diagnostics and Ipsen. A.H. Iagaru reports grants from GE Healthcare and Advanced Accelerator Applications, and nonfinancial support from Progenics Pharmaceuticals outside the submitted work. R.J. Hicks reports other from Telix Pharmaceuticals outside the submitted work. J.R. Strosberg reports personal fees from Novartis during the conduct of the study. N. Pandit-Taskar reports personal fees from Progenics during the conduct of the study. There is no disclosure or conflict of interest, employment with NIH, or received money from U.S. Government to conduct research. No disclosures were reported by the other authors.

Publisher Copyright:
© 2021 American Association for Cancer Research.

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