Treatment of neuroblastoma stage 4 with 131I-meta-iodo-benzylguanidine, high-dose chemotherapy and immunotherapy. A pilot study

Eur J Cancer. 1998 Aug;34(9):1398-402. doi: 10.1016/s0959-8049(98)00130-0.


Disseminated neuroblastoma after infancy has a prognosis of approximately 10-20% with conventional therapy. We investigated the role of high-dose chemotherapy (HDCT) with peripheral blood stem cell (PBSC) rescue in combination with 131I-metaiodobenzylguanidine ([131I-m]IBG). 11 children with neuroblastoma stage 4 were pretreated within the German Neuroblastoma Trial NB90 and included in a high-dose concept for consolidation. Remission was documented by ultrasound, CT, NMR, or [123I-m]IBG scanning. HDCT was a combination of melphalan (180 mg/m2), carboplatin (1,500 mg/m2) and etoposide (40 mg/kg). All children were treated by [131I-m]IBG (0.58 GBq/kg) prior to high-dose treatment. All 11 children were additionally treated with antiGD2 murine- or chimeric-antibody (ch14.18). 4 children had no change to their remission status but three achieved a complete response (from a partial response to first line) and one a partial response (from no response to first line). The other 3 children progressed, 2 dying of their disease. Using Kaplan-Meier analysis, the probability of progression-free survival was 0.70 +/- 0.15 with a median observation time of 19 months. 9/11 children are alive, 8 without progression or relapse, whilst 2 have died of their disease. The combination of mIBG plus high-dose chemotherapy with PBSC support supplemented by immunotherapy with antiGD2 antibody appears to be a feasible and effective treatment regimen for disseminated neuroblastoma in this limited series. Larger numbers of patients should be treated to confirm these results.

MeSH terms

  • 3-Iodobenzylguanidine / therapeutic use*
  • Antineoplastic Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Hematopoietic Stem Cell Mobilization / methods
  • Hematopoietic Stem Cell Transplantation / methods
  • Humans
  • Immunotherapy / methods*
  • Infant
  • Neuroblastoma / drug therapy
  • Neuroblastoma / therapy*
  • Pilot Projects
  • Radiopharmaceuticals / therapeutic use*
  • Risk Factors
  • Survival Analysis
  • Treatment Outcome


  • Antineoplastic Agents
  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine