Zhou MJ, Eur J Cancer (2015) (Link to Abstract)
Retrospective cohort analysis of 218 patients with refractory or relapsed neuroblastoma treated with 131I-MIBG at UCSF, San Francisco between 1996 and 2014. No significant difference in overall response rates to 131I-MIBG between patients with relapsed versus refractory neuroblastoma was seen. However, in terms of site, residual soft tissue disease a significantly have better response to 131 I-MIBG on univariate analysis compared to other sites like bone and bone marrow.
Patients with prior relapse had higher rates of progressive disease and had lower 2-year overall survival after 131I-MIBG compared to patients with refractory disease. Results showed that with 131I-MIBG, 24% of relapsed patients had progressive disease compared to only 9% of refractory patients, and 39% of relapsed patients had stable disease compared to 59% of refractory patients (p = 0.02). The 24-month OS for refractory patients was significantly higher with 65.3% compared to 38.7% for relapsed patients (p < 0.001).
*No firm conclusion can be drawn, however early start of MIBG therapy in refractory cases especially with soft tissue residual disease had better short term survival rates compared to relapsed cases in this cohort.