首页> 外文期刊>Cancers >Targeted Radionuclide Therapy for Patients with Metastatic Pheochromocytoma and Paraganglioma: From Low-Specific-Activity to High-Specific-Activity Iodine-131 Metaiodobenzylguanidine
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Targeted Radionuclide Therapy for Patients with Metastatic Pheochromocytoma and Paraganglioma: From Low-Specific-Activity to High-Specific-Activity Iodine-131 Metaiodobenzylguanidine

机译:针对转移性嗜铬细胞瘤和伞形脑瘤患者的针对性放射性核素治疗:从低比活性到高特异性活性碘-131碘苯苄基

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Low-specific-activity iodine-131–radiolabeled metaiodobenzylguanidine (I-131-MIBG) was introduced last century as a potential systemic therapy for patients with malignant pheochromocytomas and paragangliomas. Collective information derived from mainly retrospective studies has suggested that 30–40% of patients with these tumors benefit from this treatment. A low index of radioactivity, lack of therapeutic standardization, and toxicity associated with intermediate to high activities (absorbed radiation doses) has prevented the implementation of I-131-MIBG’s in clinical practice. High-specific-activity, carrier-free I-131-MIBG has been developed over the past two decades as a novel therapy for patients with metastatic pheochromocytomas and paragangliomas that express the norepinephrine transporter. This drug allows for a high level of radioactivity, and as yet is not associated with cardiovascular toxicity. In a pivotal phase two clinical trial, more than 90% of patients achieved partial responses and disease stabilization with the improvement of hypertension. Furthermore, many patients exhibited long-term persistent antineoplastic effects. Currently, the high-specific-activity I-131-MIBG is the only approved therapy in the US for patients with metastatic pheochromocytomas and paragangliomas. This review will discuss the historical development of high-specific-activity I-131-MIBG, its benefits and adverse events, and future directions for clinical practice applicability and trial development.
机译:去年世纪以潜在的恶性嗜尼计患者和恶作剧患者引入低特异性活性碘苯甲酰胍(I-131-MIBG)作为潜在的全身疗法,为恶性嗜铬细胞瘤和帕拉帕族患者的潜在全身治疗。来自主要回顾性研究的集体信息表明,30-40%的这些肿瘤患者受益于这种治疗。低放射性指数,缺乏治疗标准化和与中间体至高活性相关的毒性(吸收的辐射剂量),防止了临床实践中I-131-MIBG的实施。在过去的二十年中,在过去二十年中开发了高特异性的载体I-131-MIBG作为表达去甲肾上腺素转运蛋白转运蛋白的转移性嗜铬细胞瘤和ParAgangliomas的新疗法。该药物允许高水平的放射性,并且尚未与心血管毒性无关。在枢轴相二期临床试验中,超过90%的患者通过改善高血压来实现部分反应和疾病稳定性。此外,许多患者表现出长期持续的抗肿瘤效果。目前,高特异性的I-131-MIBG是美国转移性嗜铬细胞瘤和伞菌患者的唯一批准的批准治疗。本综述将讨论高特定活动I-131-MIBG,其益处和不良事件的历史发展,以及未来的临床实践适用性和试验发展方向。

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