MIBG imaging and 131I-MIBG therapy
A noradrenaline look-alike that neuroblastoma cells swallow: labelled with a small amount of radioactivity it shows the tumour on a scan; with a large amount it treats it.
Overview
123I-MIBG scintigraphy/SPECT is the standard staging scan (Curie score) in neuroblastoma, being partly replaced by 18F-MFBG PET. Therapeutic 131I-MIBG produces responses in ~30% of relapsed patients; COG ANBL1531 tested adding it to induction (results awaited). Also used in pheochromocytoma/paraganglioma (Azedra, discontinued 2024).
How it works
Norepinephrine transporter (NET) uptake concentrates radio-iodinated MIBG in adrenergic tumours; 131I delivers beta radiation.
- Theranostic pair with decades of use
- Targets NET-positive disease irrespective of GD2
- Prolonged isolation and radiation precautions in children
- Myelosuppression requiring stem-cell support at high doses
- Azedra withdrawal reduced supply
High-dose radioactive MIBG delivers radiation from inside neuroblastoma cells that take up noradrenaline; used for relapsed disease and tested in upfront therapy.
An injectable tracer that mimics a stress hormone and gets taken up by certain nerve-related tumours, such as pheochromocytoma and childhood neuroblastoma, so a scan afterwards can show where they are.
A radioactive tracer that mimics the body's own "fight or flight" nerve chemical and is taken up by the nerve endings in heart muscle. In people with heart failure, comparing how much of it the heart holds onto against the surrounding chest tissue gives a read on how damaged the heart's nerve supply is, which relates to future risk.
Azedra was a radioactive drug that homed in on adrenal-type tumours (phaeochromocytoma and paraganglioma) that could not be removed and delivered radiation from inside. It was approved in 2018 and discontinued by its maker in 2024.
Latest papers
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Shares Iobenguane I-123, Metastatic pheochromocytoma and paraganglioma, Pheochromocytoma and paraganglioma (PPGL), Iodine-123.
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Shares 131I-MIBG (iobenguane I-131) therapy, Neuroblastoma (paediatric), Iodine-131, Radioligand therapy (beta emitters).
- CompanyY-mAbs Therapeutics
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- IndicationHereditary pheochromocytoma and paraganglioma (SDHx, VHL, RET, NF1, MAX and TMEM127)
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- CompanyPDRadiopharma
Shares Iobenguane I-123 (cardiac use), Iodine-123, Iodine-131.
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Shares High-risk neuroblastoma, Metastatic pheochromocytoma and paraganglioma, Pheochromocytoma and paraganglioma (PPGL).