MIBG avidity correlates with clinical features, tumor biology, and outcomes in neuroblastoma: A report from the Children's Oncology Group.

Abstract

BACKGROUND:

Prior studies suggest that neuroblastomas that do not accumulate metaiodobenzylguanidine (MIBG) on diagnostic imaging (MIBG non-avid) may have more favorable features compared with MIBG avid tumors. We compared clinical features, biologic features, and clinical outcomes between patients with MIBG nonavid and MIBG avid neuroblastoma.

PROCEDURE:

Patients had metastatic high- or intermediate-risk neuroblastoma and were treated on Children's Oncology Group protocols A3973 or A3961. Comparisons of clinical and biologic features according to MIBG avidity were made with chi-squared or Fisher exact tests. Event-free (EFS) and overall (OS) survival compared using log-rank tests and modeled using Cox models.

RESULTS:

Thirty of 343 patients (8.7%) had MIBG nonavid disease. Patients with nonavid tumors were less likely to have adrenal primary tumors (34.5 vs. 57.2%; P = 0.019), bone metastases (36.7 vs. 61.7%; P = 0.008), or positive urine catecholamines (66.7 vs. 91.0%; P < 0.001) compared with patients with MIBG avid tumors. Nonavid tumors were more likely to be MYCN amplified (53.8 vs. 32.6%; P = 0.030) and had lower norepinephrine transporter expression. Patients with MIBG nonavid disease had a 5-year EFS of 50.0% compared with 38.7% for patients with MIBG avid disease (P = 0.028). On multivariate testing in high-risk patients, MIBG avidity was the sole adverse prognostic factor for EFS identified (hazard ratio 1.77; 95% confidence interval 1.04-2.99; P = 0.034).

CONCLUSIONS:

Patients with MIBG nonavid neuroblastoma have lower rates of adrenal primary tumors, bone metastasis, and catecholamine secretion. Despite being more likely to have MYCN-amplified tumors, these patients have superior outcomes compared with patients with MIBG avid disease.

• Authors: Steven G DuBois, Rajen Mody, Arlene Naranjo, Collin Van Ryn, Douglas Russ, Derek Oldridge, Susan Kreissman, David L Baker, Marguerite Parisi, Barry L Shulkin, Harrison Bai, Sharon J Diskin, Vandana Batra, John M Maris, Julie R Park, Katherine K Matthay, Gregory Yanik
• Journal: Pediatric blood & cancer (Pediatr Blood Cancer) Vol. 64 Issue 11 (Nov 2017) ISSN: 1545-5017 [Electronic] United States
• PMID: 28383813 (Publication Type: Journal Article)
• Copyright: © 2017 Wiley Periodicals, Inc.

Chemical References

• Biomarkers, Tumor
• Radiopharmaceuticals
• 3-Iodobenzylguanidine

Topics

• 3-Iodobenzylguanidine (metabolism)
• Biomarkers, Tumor (genetics)
• Cohort Studies
• Female
• Gene Expression Profiling
• Gene Expression Regulation, Neoplastic
• Humans
• Infant
• Male
• Neoplasm Staging
• Neuroblastoma (diagnostic imaging, genetics, metabolism, pathology)
• Prognosis
• Radionuclide Imaging
• Radiopharmaceuticals (metabolism)
• Survival Rate