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Iobenguane

Iobenguane I 131 is an I 131 radioiodinated synthetic analogue of the neurotransmitter norepinephrine. Iobenguane localizes to adrenergic tissue and, in radioiodinated forms, may be used to image or eradicate tumor cells that take up and metabolize norepinephrine. Check for active clinical trials or closed clinical trials using this agent. (NCI Thesaurus)

Iobenguane, also known as metaiodobenzylguanidine or mIBG, is a radiopharmaceutical. It is a radiolabeled molecule similar to norepinephrine. The isotope of iodine used can be iodine-123 (for imaging purposes only) or iodine-131 (which must be used when tissue destruction is desired). It localizes to adrenergic tissue and thus can be used to identify the location of tumors  such as phaeochromocytomas and neuroblastomas. It can also be used to eradicate tumor cells that take up and metabolize norepinephrine.

Developer:    University of Michigan (Originator), CIS Bio International (Licensee), Daiichi Radioisotope (Licensee), Neoprobe (Licensee).

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2: Meyer-Rochow GY, Schembri GP, Benn DE, Sywak MS, Delbridge LW, Robinson BG, Roach PJ, Sidhu SB. The utility of metaiodobenzylguanidine single photon emission computed tomography/computed tomography (MIBG SPECT/CT) for the diagnosis of pheochromocytoma. Ann Surg Oncol. 2010 Feb;17(2):392-400. Epub 2009 Dec 1. PubMed PMID: 19949879.

3: Taggart DR, Han MM, Quach A, Groshen S, Ye W, Villablanca JG, Jackson HA, Mari Aparici C, Carlson D, Maris J, Hawkins R, Matthay KK. Comparison of iodine-123 metaiodobenzylguanidine (MIBG) scan and [18F]fluorodeoxyglucose positron emission tomography to evaluate response after iodine-131 MIBG therapy for relapsed neuroblastoma. J Clin Oncol. 2009 Nov 10;27(32):5343-9. Epub 2009 Oct 5. PubMed PMID: 19805691; PubMed Central PMCID: PMC2773221.

4: Buckley SE, Chittenden SJ, Saran FH, Meller ST, Flux GD. Whole-body dosimetry for individualized treatment planning of 131I-MIBG radionuclide therapy for neuroblastoma. J Nucl Med. 2009 Sep;50(9):1518-24. PubMed PMID: 19713562.

5: Shilkrut M, Bar-Deroma R, Bar-Sela G, Berniger A, Kuten A. Low-dose iodine-131 metaiodobenzylguanidine therapy for patients with malignant pheochromocytoma and paraganglioma: single center experience. Am J Clin Oncol. 2010 Feb;33(1):79-82. PubMed PMID: 19704370.

6: Coleman RE, Stubbs JB, Barrett JA, de la Guardia M, Lafrance N, Babich JW. Radiation dosimetry, pharmacokinetics, and safety of ultratrace Iobenguane I-131 in patients with malignant pheochromocytoma/paraganglioma or metastatic carcinoid. Cancer Biother Radiopharm. 2009 Aug;24(4):469-75. PubMed PMID: 19694582.

7: Wiseman GA, Pacak K, O'Dorisio MS, Neumann DR, Waxman AD, Mankoff DA, Heiba SI, Serafini AN, Tumeh SS, Khutoryansky N, Jacobson AF. Usefulness of 123I-MIBG scintigraphy in the evaluation of patients with known or suspected primary or metastatic pheochromocytoma or paraganglioma: results from a prospective multicenter trial. J Nucl Med. 2009 Sep;50(9):1448-54. Epub 2009 Aug 18. PubMed PMID: 19690028.

8: Gonias S, Goldsby R, Matthay KK, Hawkins R, Price D, Huberty J, Damon L, Linker C, Sznewajs A, Shiboski S, Fitzgerald P. Phase II study of high-dose [131I]metaiodobenzylguanidine therapy for patients with metastatic pheochromocytoma and paraganglioma. J Clin Oncol. 2009 Sep 1;27(25):4162-8. Epub 2009 Jul 27. PubMed PMID: 19636009; PubMed Central PMCID: PMC2734428.

9: Vik TA, Pfluger T, Kadota R, Castel V, Tulchinsky M, Farto JC, Heiba S, Serafini A, Tumeh S, Khutoryansky N, Jacobson AF. (123)I-mIBG scintigraphy in patients with known or suspected neuroblastoma: Results from a prospective multicenter trial. Pediatr Blood Cancer. 2009 Jul;52(7):784-90. PubMed PMID: 19185008.

10: Matthay KK, Quach A, Huberty J, Franc BL, Hawkins RA, Jackson H, Groshen S, Shusterman S, Yanik G, Veatch J, Brophy P, Villablanca JG, Maris JM. Iodine-131--metaiodobenzylguanidine double infusion with autologous stem-cell rescue for neuroblastoma: a new approaches to neuroblastoma therapy phase I study. J Clin Oncol. 2009 Mar 1;27(7):1020-5. Epub 2009 Jan 26. PubMed PMID: 19171714; PubMed Central PMCID: PMC2738616.

11: Gambini JP, López Lerena JJ, Quagliata A, Hermida JC, Heuguerot C, Alonso O. 99mTc-HYNIC octreotide in neuroblastoma. Ann Nucl Med. 2008 Nov;22(9):817-9. Epub 2008 Nov 28. PubMed PMID: 19039561.

12: Koral KF, Huberty JP, Frame B, Matthay KK, Maris JM, Regan D, Normolle D, Yanik GA. Hepatic absorbed radiation dosimetry during I-131 metaiodobenzylguanidine (MIBG) therapy for refractory neuroblastoma. Eur J Nucl Med Mol Imaging. 2008 Nov;35(11):2105-12. Epub 2008 Aug 6. PubMed PMID: 18682939.

13: Schmidt M, Simon T, Hero B, Schicha H, Berthold F. The prognostic impact of functional imaging with (123)I-mIBG in patients with stage 4 neuroblastoma >1 year of age on a high-risk treatment protocol: results of the German Neuroblastoma Trial NB97. Eur J Cancer. 2008 Jul;44(11):1552-8. Epub 2008 Apr 16. PubMed PMID: 18424129.

14: Nakajo M, Yoshinaga K, Oriuchi N, Kinuya S, Yokoyama K, Yamaguchi T; Drafting Committee for Guideline of Internal Radiotherapy with 131I-MIBG; Japanese Society of Nuclear Medicine in Oncology and Immunology; Japanese Society of Nuclear Medicine. [Guideline draft of appropriate use of 131I-MIBG for internal radiotherapy of neuroendocrine tumors]. Kaku Igaku. 2008 Feb;45(1):suppl 1-40. Japanese. PubMed PMID: 19594094.

15: Buckley SE, Saran FH, Gaze MN, Chittenden S, Partridge M, Lancaster D, Pearson A, Flux GD. Dosimetry for fractionated (131)I-mIBG therapies in patients with primary resistant high-risk neuroblastoma: preliminary results. Cancer Biother Radiopharm. 2007 Feb;22(1):105-12. PubMed PMID: 17627418.

16: Flux G, Bardies M, Chiesa C, Monsieurs M, Savolainen S, Strand SE, Lassmann M. Clinical radionuclide therapy dosimetry: the quest for the "Holy Gray". Eur J Nucl Med Mol Imaging. 2007 Oct;34(10):1699-700. PubMed PMID: 17565497.

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18: Matthay KK, Yanik G, Messina J, Quach A, Huberty J, Cheng SC, Veatch J, Goldsby R, Brophy P, Kersun LS, Hawkins RA, Maris JM. Phase II study on the effect of disease sites, age, and prior therapy on response to iodine-131-metaiodobenzylguanidine therapy in refractory neuroblastoma. J Clin Oncol. 2007 Mar 20;25(9):1054-60. PubMed PMID: 17369569.

19: Brans B, Bodei L, Giammarile F, Linden O, Luster M, Oyen WJ, Tennvall J. Clinical radionuclide therapy dosimetry: the quest for the "Holy Gray". Eur J Nucl Med Mol Imaging. 2007 May;34(5):772-86. Review. PubMed PMID: 17268773; PubMed Central PMCID: PMC1914264.

20: Gao ZR, An R, Zhang YX, Biersack HJ. [Targeted radionuclide therapy for patients with metastatic medullary thyroid carcinoma]. Zhonghua Zhong Liu Za Zhi. 2006 Aug;28(8):621-4. Chinese. PubMed PMID: 17236560.

21: Sudbrock F, Eschner W, Schmidt M, Simon T, Hero B, Schicha H. [Dosimetry for therapeutic treatment of neuroblastoma by 131I-mIBG]. Nuklearmedizin. 2006;45(6):254-61. German. PubMed PMID: 17149494.

22: Fitzgerald PA, Goldsby RE, Huberty JP, Price DC, Hawkins RA, Veatch JJ, Dela Cruz F, Jahan TM, Linker CA, Damon L, Matthay KK. Malignant pheochromocytomas and paragangliomas: a phase II study of therapy with high-dose 131I-metaiodobenzylguanidine (131I-MIBG). Ann N Y Acad Sci. 2006 Aug;1073:465-90. PubMed PMID: 17102115.

23: Schmidt M, Simon T, Hero B, Eschner W, Dietlein M, Sudbrock F, Bongartz R, Berthold F, Schicha H. Is there a benefit of 131 I-MIBG therapy in the treatment of children with stage 4 neuroblastoma? A retrospective evaluation of The German Neuroblastoma Trial NB97 and implications for The German Neuroblastoma Trial NB2004. Nuklearmedizin. 2006;45(4):145-51; quiz N39-40. PubMed PMID: 16964339.

24: Lumachi F, Tregnaghi A, Zucchetta P, Cristina Marzola M, Cecchin D, Grassetto G, Bui F. Sensitivity and positive predictive value of CT, MRI and 123I-MIBG scintigraphy in localizing pheochromocytomas: a prospective study. Nucl Med Commun. 2006 Jul;27(7):583-7. PubMed PMID: 16794519.

25: Matthay KK, Tan JC, Villablanca JG, Yanik GA, Veatch J, Franc B, Twomey E, Horn B, Reynolds CP, Groshen S, Seeger RC, Maris JM. Phase I dose escalation of iodine-131-metaiodobenzylguanidine with myeloablative chemotherapy and autologous stem-cell transplantation in refractory neuroblastoma: a new approaches to Neuroblastoma Therapy Consortium Study. J Clin Oncol. 2006 Jan 20;24(3):500-6. PubMed PMID: 16421427.

26: Mann GN, Link JM, Pham P, Pickett CA, Byrd DR, Kinahan PE, Krohn KA, Mankoff DA. [11C]metahydroxyephedrine and [18F]fluorodeoxyglucose positron emission tomography improve clinical decision making in suspected pheochromocytoma. Ann Surg Oncol. 2006 Feb;13(2):187-97. Epub 2006 Jan 19. PubMed PMID: 16418883.

27: Oudoux A, Bridji B, Resche I, Ricaud M, Douillard JY, Chatal JF, Rousseau C. [Radiation therapy with 131I-MIBG is still relevant for metastatic carcinoid tumors]. Gastroenterol Clin Biol. 2005 Aug-Sep;29(8-9):935-8. French. PubMed PMID: 16294166.

28: Lam MG, Lips CJ, Jager PL, Dullaart RP, Lentjes EG, van Rijk PP, de Klerk JM. Repeated [131I]metaiodobenzylguanidine therapy in two patients with malignant pheochromocytoma. J Clin Endocrinol Metab. 2005 Oct;90(10):5888-95. Epub 2005 Jul 26. PubMed PMID: 16046591.

29: Gaze MN, Chang YC, Flux GD, Mairs RJ, Saran FH, Meller ST. Feasibility of dosimetry-based high-dose 131I-meta-iodobenzylguanidine with topotecan as a radiosensitizer in children with metastatic neuroblastoma. Cancer Biother Radiopharm. 2005 Apr;20(2):195-9. PubMed PMID: 15869455.

30: Sakata K, Iida K, Kudo M, Yoshida H, Doi O. Prognostic value of I-123 metaiodobenzylguanidine imaging in vasospastic angina without significant coronary stenosis. Circ J. 2005 Feb;69(2):171-6. PubMed PMID: 15671608.

31: Valteau-Couanet D, Michon J, Boneu A, Rodary C, Perel Y, Bergeron C, Rubie H, Coze C, Plantaz D, Bernard F, Chastagner P, Bouzy J, Hartmann O. Results of induction chemotherapy in children older than 1 year with a stage 4 neuroblastoma treated with the NB 97 French Society of Pediatric Oncology (SFOP) protocol. J Clin Oncol. 2005 Jan 20;23(3):532-40. PubMed PMID: 15659499.

32: Pashankar FD, O'Dorisio MS, Menda Y. MIBG and somatostatin receptor analogs in children: current concepts on diagnostic and therapeutic use. J Nucl Med. 2005 Jan;46 Suppl 1:55S-61S. Review. PubMed PMID: 15653652.

33: Chew SL. Recent developments in the therapy of phaeochromocytoma. Expert Opin Investig Drugs. 2004 Dec;13(12):1579-83. Review. PubMed PMID: 15566315.

34: Maurea S, Caracò C, Klain M, Mainolfi C, Salvatore M. Imaging characterization of non-hypersecreting adrenal masses. Comparison between MR and radionuclide techniques. Q J Nucl Med Mol Imaging. 2004 Sep;48(3):188-97. PubMed PMID: 15499292.

35: Nguyen C, Faraggi M, Giraudet AL, de Labriolle-Vaylet C, Aparicio T, Rouzet F, Mignon M, Askienazy S, Sobhani I. Long-term efficacy of radionuclide therapy in patients with disseminated neuroendocrine tumors uncontrolled by conventional therapy. J Nucl Med. 2004 Oct;45(10):1660-8. PubMed PMID: 15471830.

36: Katzenstein HM, Cohn SL, Shore RM, Bardo DM, Haut PR, Olszewski M, Schmoldt J, Liu D, Rademaker AW, Kletzel M. Scintigraphic response by 123I-metaiodobenzylguanidine scan correlates with event-free survival in high-risk neuroblastoma. J Clin Oncol. 2004 Oct 1;22(19):3909-15. PubMed PMID: 15459212.

37: Zuetenhorst JM, Valdes Olmos RA, Muller M, Hoefnagel CA, Taal BG. Interferon and meta-iodobenzylguanidin combinations in the treatment of metastatic carcinoid tumours. Endocr Relat Cancer. 2004 Sep;11(3):553-61. PubMed PMID: 15369454.

38: Gao Z, Biersack HJ, Ezziddin S, Logvinski T, An R. The role of combined imaging in metastatic medullary thyroid carcinoma: 111In-DTPA-octreotide and 131I/123I-MIBG as predictors for radionuclide therapy. J Cancer Res Clin Oncol. 2004 Nov;130(11):649-56. Epub 2004 Aug 5. PubMed PMID: 15300425.

39: DuBois SG, Messina J, Maris JM, Huberty J, Glidden DV, Veatch J, Charron M, Hawkins R, Matthay KK. Hematologic toxicity of high-dose iodine-131-metaiodobenzylguanidine therapy for advanced neuroblastoma. J Clin Oncol. 2004 Jun 15;22(12):2452-60. PubMed PMID: 15197208.

40: Brophy P, Schmus C, Balistreri L. Meeting the nursing challenges in treating children with 131I-MIBG. J Pediatr Oncol Nurs. 2004 Jan;21(1):9-15. PubMed PMID: 15058401.

41: Hashimoto T, Koizumi K, Nishina T, Abe K. Clinical usefulness of iodine-123-MIBG scintigraphy for patients with neuroblastoma detected by a mass screening survey. Ann Nucl Med. 2003 Dec;17(8):633-40. PubMed PMID: 14971604.

42: Castellani MR, Alessi A, Savelli G, Bombardieri E. The role of radionuclide therapy in medullary thyroid cancer. Tumori. 2003 Sep-Oct;89(5):560-2. Review. PubMed PMID: 14870787.

43: Sakata K, Yoshida H, Tamekiyo H, Obayashi K, Nawada R, Doi O, Mori N. Comparative effect of clinidipine and quinapril on left ventricular mass in mild essential hypertension. Drugs Exp Clin Res. 2003;29(3):117-23. PubMed PMID: 14708457.

44: Ilias I, Yu J, Carrasquillo JA, Chen CC, Eisenhofer G, Whatley M, McElroy B, Pacak K. Superiority of 6-[18F]-fluorodopamine positron emission tomography versus [131I]-metaiodobenzylguanidine scintigraphy in the localization of metastatic pheochromocytoma. J Clin Endocrinol Metab. 2003 Sep;88(9):4083-7. PubMed PMID: 12970267.

45: Monsieurs M, Brans B, Bacher K, Dierckx R, Thierens H. Patient dosimetry for 131I-MIBG therapy for neuroendocrine tumours based on 123I-MIBG scans. Eur J Nucl Med Mol Imaging. 2002 Dec;29(12):1581-7. Epub 2002 Oct 2. PubMed PMID: 12458391.

46: Zuetenhorst JM, Hoefnageli CA, Boot H, Valdés Olmos RA, Taal BG. Evaluation of (111)In-pentetreotide, (131)I-MIBG and bone scintigraphy in the detection and clinical management of bone metastases in carcinoid disease. Nucl Med Commun. 2002 Aug;23(8):735-41. PubMed PMID: 12124478.

47: Okuyama C, Ushijima Y, Kubota T, Nakamura T, Kikkawa M, Nishimura T. Utility of follow-up studies using meta-[123 I]iodobenzylguanidine scintigraphy for detecting recurrent neuroblastoma. Nucl Med Commun. 2002 Jul;23(7):663-72. PubMed PMID: 12089489.

48: Yanik GA, Levine JE, Matthay KK, Sisson JC, Shulkin BL, Shapiro B, Hubers D, Spalding S, Braun T, Ferrara JL, Hutchinson RJ. Pilot study of iodine-131-metaiodobenzylguanidine in combination with myeloablative chemotherapy and autologous stem-cell support for the treatment of neuroblastoma. J Clin Oncol. 2002 Apr 15;20(8):2142-9. PubMed PMID: 11956276.

49: Hartley A, Spooner D, Brunt AM. Management of malignant phaeochromocytoma: a retrospective review of the use of MIBG and chemotherapy in the West Midlands. Clin Oncol (R Coll Radiol). 2001;13(5):361-6. PubMed PMID: 11716230.

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51: Matthay KK, Panina C, Huberty J, Price D, Glidden DV, Tang HR, Hawkins RA, Veatch J, Hasegawa B. Correlation of tumor and whole-body dosimetry with tumor response and toxicity in refractory neuroblastoma treated with (131)I-MIBG. J Nucl Med. 2001 Nov;42(11):1713-21. PubMed PMID: 11696644.

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53: Hero B, Hunneman DH, Gahr M, Berthold F. Evaluation of catecholamine metabolites, mIBG scan, and bone marrow cytology as response markers in stage 4 neuroblastoma. Med Pediatr Oncol. 2001 Jan;36(1):220-3. PubMed PMID: 11464889.

54: Ekelund S, Nygren P, Larsson R. Guanidino-containing drugs in cancer chemotherapy: biochemical and clinical pharmacology. Biochem Pharmacol. 2001 May 15;61(10):1183-93. Review. PubMed PMID: 11322922.

55: Miano M, Garaventa A, Pizzitola MR, Piccolo MS, Dallorso S, Villavecchia GP, Bertolazzi C, Cabria M, De Bernardi B. Megatherapy combining I(131) metaiodobenzylguanidine and high-dose chemotherapy with haematopoietic progenitor cell rescue for neuroblastoma. Bone Marrow Transplant. 2001 Mar;27(6):571-4. PubMed PMID: 11319584.

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59: Hoefnagel CA, Taal BG, Sivro F, Boot H, Valdes Olmos RA. Enhancement of 131I-MIBG uptake in carcinoid tumours by administration of unlabelled MIBG. Nucl Med Commun. 2000 Aug;21(8):755-61. PubMed PMID: 11039459.

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62: Owens J, Bolster AA, Prosser JE, Cunningham S, Mairs RJ, Neilly JB, Reed NS, Hilditch TE. No-carrier-added 123I-MIBG: an initial clinical study in patients with phaeochromocytoma. Nucl Med Commun. 2000 May;21(5):437-40. PubMed PMID: 10874700.

63: Suga K, Ogasawara N, Ariga M, Motoyama K, Hara A, Kume N, Matsunaga N. Alteration of myocardial metaiodobenzylguanidine uptake after treatment of phaeochromocytoma and neuroblastoma. Eur J Nucl Med. 2000 May;27(5):574-82. PubMed PMID: 10853814.

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