Kayano Daiki, Kinuya Seigo
1Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641 Japan.
2Department of Nuclear Medicine, Fukushima Medical University Hospital, 1 Hikariga-oka, Fukushima, 960-1295 Japan.
Nucl Med Mol Imaging. 2018 Aug;52(4):254-265. doi: 10.1007/s13139-018-0523-z. Epub 2018 May 3.
Metaiodobenzylguanidine (MIBG) is structurally similar to the neurotransmitter norepinephrine and specifically targets neuroendocrine cells including some neuroendocrine tumors. Iodine-131 (I-131)-labeled MIBG (I-131 MIBG) therapy for neuroendocrine tumors has been performed for more than a quarter-century. The indications of I-131 MIBG therapy include treatment-resistant neuroblastoma (NB), unresectable or metastatic pheochromocytoma (PC) and paraganglioma (PG), unresectable or metastatic carcinoid tumors, and unresectable or metastatic medullary thyroid cancer (MTC). I-131 MIBG therapy is one of the considerable effective treatments in patients with advanced NB, PC, and PG. On the other hand, I-131 MIBG therapy is an alternative method after more effective novel therapies are used such as radiolabeled somatostatin analogs and tyrosine kinase inhibitors in patients with advanced carcinoid tumors and MTC. No-carrier-aided (NCA) I-131 MIBG has more favorable potential compared to the conventional I-131 MIBG. Astatine-211-labeled meta-astatobenzylguanidine (At-211 MABG) has massive potential in patients with neuroendocrine tumors. Further studies about the therapeutic protocols of I-131 MIBG including NCA I-131 MIBG in the clinical setting and At-211 MABG in both the preclinical and clinical settings are needed.
间碘苄胍（MIBG）在结构上与神经递质去甲肾上腺素相似，并且特异性靶向神经内分泌细胞，包括一些神经内分泌肿瘤。碘-131（I-131）标记的MIBG（I-131 MIBG）治疗神经内分泌肿瘤已开展了超过四分之一个世纪。I-131 MIBG治疗的适应证包括难治性神经母细胞瘤（NB）、不可切除或转移性嗜铬细胞瘤（PC）和副神经节瘤（PG）、不可切除或转移性类癌肿瘤以及不可切除或转移性甲状腺髓样癌（MTC）。I-131 MIBG治疗是晚期NB、PC和PG患者相当有效的治疗方法之一。另一方面，对于晚期类癌肿瘤和MTC患者，在使用更有效的新型疗法如放射性标记的生长抑素类似物和酪氨酸激酶抑制剂后，I-131 MIBG治疗是一种替代方法。与传统的I-131 MIBG相比，无载体添加（NCA）I-131 MIBG具有更有利的潜力。砹-211标记的间砹苄胍（At-211 MABG）在神经内分泌肿瘤患者中具有巨大潜力。需要进一步研究I-131 MIBG（包括临床环境中的NCA I-131 MIBG）以及临床前和临床环境中的At-211 MABG的治疗方案。
