| Summary: | Despite improvements in neuroblastoma treatment, survival figures lag behind those of
many other childhood malignancies. New treatments, and better use of existing treatments,
are essential to reduce mortality. Neuroblastoma expresses several molecular targets for
radionuclide imaging and therapy, of which the most widely exploited is the norepinephrine
transporter. [
123I]meta iodobenzylguanidine (mIBG) imaging and [131I]mIBG treatment, which
target this physiological pathway, have been in clinical practice for 40 years. While therapy
outcomes have been favourable, [
131I]mIBG use has not yet been optimized. Somatostatin
receptors and the disialoganglioside (GD2) are alternative targets, but their use remains
experimental. The charity Friends of Rosie organized a workshop bringing together a broad
range of scientists including radiochemists, radiobiologists, radiation physicists, clinical
researchers including pediatric oncologists and nuclear medicine physicians, and patient
advocates from the United Kingdom (UK), United States of America (USA) and continental
Europe to share their experiences with molecular imaging and radiotherapy of
neuroblastoma, and discuss potential ways of improving treatment outcomes and access.
These include development of alternative vectors targeting somatostatin receptors and
GD2, isotopes such as alpha particle and Auger electron emitters with different radiation
characteristics, and combinations with external beam radiotherapy, immunotherapy and
deoxyribonucleic acid (DNA) damage repair inhibitors. Barriers to progress discussed
included insecure radioisotope supply, production of novel radiopharmaceuticals, lack of
data regarding which are the best combination therapies, and insufficient clinical facilities.
The aim was to stimulate the development and assessment of more effective treatments.
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