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High-dose radioactive MIBG delivers radiation from inside neuroblastoma cells that take up noradrenaline; used for relapsed disease and tested in upfront therapy. A branded high-specific-activity form, Azedra, was approved for phaeochromocytoma and paraganglioma in 2018 and discontinued in 2024.
Response rate ~30-40% in relapsed/refractory MIBG-avid neuroblastoma (NANT, COG studies), with myelosuppression requiring stem-cell support at ≥12 mCi/kg. COG ANBL1531 randomised 131I-MIBG added to induction (primary results pending 2026).
High-specific-activity iobenguane I-131 (Azedra, Progenics then Lantheus) was approved by the FDA in July 2018 for adults and children aged 12 and over with iobenguane scan-positive, unresectable, locally advanced or metastatic phaeochromocytoma or paraganglioma requiring systemic therapy, on a single-arm phase 2 study in which a quarter of patients halved their antihypertensive medication for at least six months and most had tumour control; it was the first approved therapy for these tumours. Lantheus discontinued manufacture in 2024, so patients rely on compounded low-specific-activity 131I-MIBG or lutetium-177 dotatate. Myelosuppression, secondary MDS and leukaemia, hypothyroidism and renal toxicity are the main risks; the diagnostic-dose iobenguane (AdreView) is an imaging agent covered under MIBG theranostics.
Norepinephrine transporter uptake of radio-iodinated benzylguanidine; 131I beta emission (2 mm range).
1.131I-MIBG (iobenguane I-131) therapy binds its target on the cancer cell or is taken up by it.
| Region | Year | Indication |
|---|---|---|
| US | 2018 | Iobenguane scan-positive unresectable, locally advanced or metastatic phaeochromocytoma or paraganglioma in patients 12 and older (Azedra, high-specific-activity form; discontinued 2024) |
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Query for this drug: (TITLE:"131I-MIBG iobenguane I-131 therapy" OR ABSTRACT:"131I-MIBG iobenguane I-131 therapy" OR TITLE:"Azedra" OR ABSTRACT:"Azedra" OR TITLE:"Iobenguane I-131 therapeutic" OR ABSTRACT:"Iobenguane I-131 therapeutic" OR TITLE:"131I-MIBG" OR ABSTRACT:"131I-MIBG" OR TITLE:"Ultratrace iobenguane" OR ABSTRACT:"Ultratrace iobenguane" OR TITLE:"iobenguane-i-131" OR ABSTRACT:"iobenguane-i-131") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about 131I-MIBG (iobenguane I-131) therapy, not a curated reading list.
Shares MIBG Curie and SIOPEN scores, MIBG imaging and 131I-MIBG therapy, High-risk neuroblastoma, Neuroblastoma (paediatric).
Shares MIBG imaging and 131I-MIBG therapy, High-risk neuroblastoma, Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Neuroblastoma (paediatric).
Shares Lantheus, Radioligand therapy (beta emitters), Neuroendocrine tumours.
Shares Pheochromocytoma and paraganglioma (PPGL), Lutetium-177 dotatate, Radioligand therapy (beta emitters).
Shares MIBG Curie and SIOPEN scores, High-risk neuroblastoma, Neuroblastoma (paediatric).
Shares High-risk neuroblastoma, Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Neuroblastoma (paediatric).
Shares High-risk neuroblastoma, Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first, Neuroblastoma (paediatric).
Shares COG ANBL1531, Neuroblastoma (paediatric).