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

MIBG avidity correlates with clinical features, tumor biology, and outcomes in neuroblastoma: A report from the Children’s Oncology Group
Neuroblastomas that are MIBG non-avid may have more favorable characteristics compared with MIBG avid tumors. Prior work from this group demonstrated that MIBG non-avid tumors lead to superior event-free survival (EFS) compared to MIBG avid tumors in high-risk disease. The goal of this study was to compare clinical features, tumor biology, and clinical outcomes between patients with MIBG avid and non-avid disease for patients with intermediate- and high-risk disease. This study was conducted by the COG.
Patients had metastatic high- or intermediate-risk neuroblastoma and treated on COG protocols A3973 or A3961. Clinical and biologic features according to MIBG avidity were compared. EFS and overall survival (OS) were compared.
Three-hundred and six patients had high-risk disease, and 37 had intermediate-risk disease. Thirty of 343 patients (8.7%) had MIBG non-avid disease. Non-avid tumors were less likely to have adrenal primary tumors, bone metastases, and positive urine catecholamines compared with MIBG avid tumors. Non-avid tumors were more likely to be MYCN amplified and had lower norepinephrine transporter expression. The 5-year EFS for MIBG non-avid tumors was 50% compared with 38.7% for MIBG avid tumors (p=0.028). In high-risk patients, MIBG avidity was the sole adverse prognostic factor for EFS.
This analysis was limited to patients with metastatic disease. It is not clear if these results can be generalized to non-metastatic disease.
Patients with MIBG non-avid tumors had superior outcomes compared with MIBG avid disease, despite a higher likelihood of MYCN amplification.