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Use of m-[¹³¹I]Iodobenzylguanidine in the Treatment of Malignant Pheochromocytoma

University Hospital (MX., B.C., J.F.C.) 44035 Nantes, France
Institut Gustaue-Roussy (J.L., B.A., M.S.) 94805 Villejuif, France
University Hospital (R.M., M.C.F.-G., B.L.) 69437 Lyon, France
University Hospital (A.J.B., M.G.) 33076 Bordeaux, France
Centre Oscar Lambret and University Hospital (J.L. W., P.C., X.M.) 59003 Lille, France
Institut Jean Godinot (M.J.D., C.G.) 51056 Reims, France

Address all correspondence and requests for reprints to: Dr. Michel Krempf, Clinique Endocrinologique, Place Alexis Ricordeau, Hôtel Dieu, 44035 Nantes Cedex, France.

The efficacy and safety of m-[¹³¹I]iodobenzylguanidine ([¹³¹I]MIBG) were assessed in 15 patients with malignant pheochromocytomas in a nonrandomized, single arm trial, in which patients were treated with [¹³¹I]MIBG (SA, 740 megabequerel/mg) every 3 months. Seven of these patients had bone and soft tissue metastases, 4 had only soft metastases, and 4 had only bone metastases. The follow-up period ranged from 6–54 months; the number of doses ranged from 2–11, with 2.9 (78.4 mCi) to 9.25 gigabequerel (GBq) (250 mCi)/administration and a cumulative activity from 11.1–85.90 GBq (300–2322 mCi). The absorbed cumulative dose in tumors ranged from 12–155 Gy. A beneficial effect of the treatment was observed in 9 patients (60%). No complete remission of the disease was observed. Seven patients died during the study, among whom 4 never responded to the treatment. Seven had hormonal responses (4 complete and 3 partial), with a duration ranging from 5–48 months. Among these patients, 4 relapsed, and 3 died within 3 months. Five patients had partial tumoral responses mainly located in soft tissues and for a duration ranging from 29–54 months. All patients with a hormonal response had objective improvement in clinical status and blood pressure. There was no clear-cut relationship between the cumulative dose and the responses. The main side-effect observed in 1 patient with widespread bone metastases after three doses (12.9 GBq) was a pancytopenia, which resolved after treatment was discontinued. This study suggests that repeated [¹³¹I]MIBG treatment could be effective in patients with advanced malignant pheochromocytoma.

Received January 2, 1990.

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