Targeted radionuclide therapies using 131I-metaiodobenzylguanidine (131I-MIBG) and peptide receptor radionuclide therapy (177Lu or 90Y) represent several of the therapeutic options in the management of metastatic or inoperable pheochromocytoma and/or paraganglioma (PPGL). 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 (NCCN) guidelines for the treatment of metastatic PPGL. However, a clinical dilemma often arises in the selection of targeted radionuclide therapy, especially when a patient can be treated with either type of therapy based on eligibility by MIBG and somatostatostatin receptor imaging. In order 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 targeted radionuclide therapies in order to develop consensus and provide expert recommendations and perspectives on how to select between these two therapeutic options for metastatic PPGL. This manuscript aims to summarize the survival outcomes of the available targeted radionuclide therapies, discuss personalized treatment strategies based on functional imaging scans, address practical issues including regulatory approvals, and compare toxicities and risk factors across treatments. Further, it discusses the emerging targeted radionuclide therapies.
View details for DOI 10.1158/1078-0432.CCR-20-3703
View details for PubMedID 33685867