Abstract
Neuroblastoma (NB) represents the most common extracranial tumor of childhood. Prognosis is quite variable, ranging from spontaneous regression to aggressive behavior with wide metastatization, high mortality, and limited therapeutic options. Radiotheranostics combines a radiopharmaceutical pair in a unique approach, suitable both for diagnosis and therapy. For many years, metaiodobenzylguanidine (MIBG), labeled with 123I for imaging or 131I for therapy, has represented the main theranostic agent in NB, since up to 90% of NB incorporates the aforementioned radiopharmaceutical. In recent years, novel theranostic agents hold promise in moving the field of NB radiotheranostics forward. In particular, SarTATE, consisting of octreotate targeting somatostatin receptors, has been applied with encouraging results, with 64Cu-SARTATE being used for disease detection and with 67Cu-SARTATE being used for therapy. Furthermore, recent evidence has highlighted the potential of targeted alpha therapy (TAT) for treating cancer by virtue of alpha particles’ high ionizing density and high probability of killing cells along their track. On this path, 211At-astatobenzylguanidine (MABG) has been developed as a potential agent for TAT and is actually under evaluation in preclinical NB models. In this review, we performed a web-based and desktop literature research concerning radiotheranostic approaches in NB, covering both the radiopharmaceuticals already implemented in clinical practice (i.e.,123/1311-MIBG) and those still in a preliminary or preclinical phase.
Highlights
Neuroblastoma (NB) represents the most common extracranial tumor in childhood and can arise anywhere along the sympathetic chain, adrenal glands represent its most common location [1]
Blood pressure monitoring and pre-therapy antiemetic drugs as well as proper hydration are recommended to promote 131 I renal excretion, reducing patient radiation [12]
Network (SIOPEN) scoring method divides the body into 12 bone segments; each segment is given a score of 0–6: one, two, or three for distinct MIBG-avid lesions; four when there is less than 50% diffuse MIBG uptake in a segment; 5 when there is between 50% and 95%
Summary
Neuroblastoma (NB) represents the most common extracranial tumor in childhood and can arise anywhere along the sympathetic chain, adrenal glands represent its most common location [1] It accounts for 12–15% of all cancer-related death at pediatric ages, with 40% of patients being younger than 1 year while less than 5% being older than 10 years [2]. Paraneoplastic syndromes have been reported in NB, mainly consisting of secretory diarrhea (due to the production of vasoactive intestinal peptide) and opsoclonus myoclonus ataxia syndrome (OMS) [4] As far as it concerns genetic aspects, activating mutations in the tyrosine kinase domain of the anaplastic lymphoma kinase (ALK) oncogene has been found in the majority of hereditary NB [5]. Stage 2B: localized tumor with or without complete gross excision; positive ipsilateral lymph node for tumor; enlarged contralateral lymphnodes should be histologically negative. Stage 4S: Stages 1, 2A, or 2B primary tumor in patients with less than one year of age with dissemination limited to the skin, liver, or bone marrow (
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
