High Dose Chemotherapy with MIBG I131 in Treatment of Patients with Neuroblastoma of High-Risk: a Cohort Study

Abstract

Background. Poor-risk neuroblastoma treatment is still a challenge because of high relapse rate. Combination of high dose chemotherapy (HDCT) with MIBG I131 radiotherapy is a relatively new strategy for consolidation regimens in some patients with neuroblastoma. Objective. The aim of the study was to assess the safety and efficacy of a complex consolidation in a treatment of high-risk neuroblastoma patients in a pilot clinical trial. Methods. In our cohort study we analyzed toxicity along with 2- and 4- years OS and EFS in a cohort of 12 patients who got a consolidation based on Treo/ Mel HDCT in combination with MIBG I¹³¹ as a part of high-risk neuroblastoma treatment protocol since 2014 till 2018. The study was conducted in the Pediatric Oncology and Hematology Scientific Research Institute of Blokhin’s National Medical Cancer Research Center (Moscow). The treatment with MIBG I¹³¹ was done in settings of isolated ward of Russian Scientific Center of Roentgenology and Radiology. Results. Maximum cumulative organ toxicity of grade 2 or less was seen in 92% of patients. There was no treatment-related mortality. OS for 2 and 4 years was 87,5% ± 11,7% (for both time points). EFS for 2 and 4 years – 61,4 ± 15,3% and 49,1 ± 16,4%, respectively. Conclusion. Consolidation regimen based on Treo/Mel with MIBG I¹³¹ is safe. As a part of treatment program, it provides 4-years EFS for about a half of patients with poor-risk neuroblastoma with active residual tumor at the moment of consolidation.