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Predictors of Survival in 211 Patients with Stage IV Pulmonary and Gastroenteropancreatic MIBG-Positive Neuroendocrine Tumors Treated with 131I-MIBG.

Publication ,  Journal Article
Kane, A; Thorpe, MP; Morse, MA; Howard, BA; Oldan, JD; Zhu, J; Wong, TZ; Petry, NA; Reiman, R; Borges-Neto, S
Published in: J Nucl Med
November 2018

This retrospective analysis identifies predictors of survival in a cohort of patients with meta-iodobenzylguanidine (MIBG)-positive stage IV pulmonary and gastroenteropancreatic neuroendocrine tumor (P/GEP-NET) treated with 131I-MIBG therapy, to inform treatment selection and posttreatment monitoring. Methods: Survival, symptoms, imaging, and biochemical response were extracted via chart review from 211 P/GEP-NET patients treated with 131I-MIBG between 1991 and 2014. For patients with CT follow-up (n = 125), imaging response was assessed by RECIST 1.1 if images were available (n = 76) or by chart review of the radiology report if images could not be reviewed (n = 49). Kaplan-Meier analysis and Cox multivariate regression estimated survival and progression-free survival benefits predicted by initial imaging, biochemical response, and symptomatic response. Results: All patients had stage IV disease at the time of treatment. Median survival was 29 mo from the time of treatment. Symptomatic response was seen in 71% of patients, with the median duration of symptomatic relief being 12 mo. Symptomatic response at the first follow-up predicted a survival benefit of 30 mo (P < 0.001). Biochemical response at the first clinical follow-up was seen in 34% of patients, with stability of laboratory values in 48%; response/stability versus progression extended survival by 40 mo (P < 0.03). Imaging response (20% of patients) or stability (60%) at the initial 3-mo follow-up imaging extended survival by 32 mo (P < 0.001). Additionally, multiple 131I-MIBG treatments were associated with 24 mo of additional survival (P < 0.05). Conclusion: Therapeutic 131I-MIBG for metastatic P/GEP-NETs appears to be an effective means of symptom palliation. Imaging, biochemical, and symptomatic follow-up help prognosticate expected survival after 131I-MIBG therapy. Multiple rounds of 131I-MIBG are associated with prolonged survival.

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Published In

J Nucl Med

DOI

EISSN

1535-5667

Publication Date

November 2018

Volume

59

Issue

11

Start / End Page

1708 / 1713

Location

United States

Related Subject Headings

  • Stomach Neoplasms
  • Retrospective Studies
  • Radiopharmaceuticals
  • Proportional Hazards Models
  • Progression-Free Survival
  • Pancreatic Neoplasms
  • Nuclear Medicine & Medical Imaging
  • Neuroendocrine Tumors
  • Middle Aged
  • Male
 

Citation

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Kane, A., Thorpe, M. P., Morse, M. A., Howard, B. A., Oldan, J. D., Zhu, J., … Borges-Neto, S. (2018). Predictors of Survival in 211 Patients with Stage IV Pulmonary and Gastroenteropancreatic MIBG-Positive Neuroendocrine Tumors Treated with 131I-MIBG. J Nucl Med, 59(11), 1708–1713. https://doi.org/10.2967/jnumed.117.202150
Kane, Ari, Matthew P. Thorpe, Michael A. Morse, Brandon A. Howard, Jorge D. Oldan, Jason Zhu, Terence Z. Wong, Neil A. Petry, Robert Reiman, and Salvador Borges-Neto. “Predictors of Survival in 211 Patients with Stage IV Pulmonary and Gastroenteropancreatic MIBG-Positive Neuroendocrine Tumors Treated with 131I-MIBG.J Nucl Med 59, no. 11 (November 2018): 1708–13. https://doi.org/10.2967/jnumed.117.202150.
Kane A, Thorpe MP, Morse MA, Howard BA, Oldan JD, Zhu J, et al. Predictors of Survival in 211 Patients with Stage IV Pulmonary and Gastroenteropancreatic MIBG-Positive Neuroendocrine Tumors Treated with 131I-MIBG. J Nucl Med. 2018 Nov;59(11):1708–13.
Kane, Ari, et al. “Predictors of Survival in 211 Patients with Stage IV Pulmonary and Gastroenteropancreatic MIBG-Positive Neuroendocrine Tumors Treated with 131I-MIBG.J Nucl Med, vol. 59, no. 11, Nov. 2018, pp. 1708–13. Pubmed, doi:10.2967/jnumed.117.202150.
Kane A, Thorpe MP, Morse MA, Howard BA, Oldan JD, Zhu J, Wong TZ, Petry NA, Reiman R, Borges-Neto S. Predictors of Survival in 211 Patients with Stage IV Pulmonary and Gastroenteropancreatic MIBG-Positive Neuroendocrine Tumors Treated with 131I-MIBG. J Nucl Med. 2018 Nov;59(11):1708–1713.

Published In

J Nucl Med

DOI

EISSN

1535-5667

Publication Date

November 2018

Volume

59

Issue

11

Start / End Page

1708 / 1713

Location

United States

Related Subject Headings

  • Stomach Neoplasms
  • Retrospective Studies
  • Radiopharmaceuticals
  • Proportional Hazards Models
  • Progression-Free Survival
  • Pancreatic Neoplasms
  • Nuclear Medicine & Medical Imaging
  • Neuroendocrine Tumors
  • Middle Aged
  • Male