Azedra (iobenguane I 131)

Another notable feature in this case was the visually evident intra- and inter-tumoral metabolic heterogeneity on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography, especially within the multiple carotid paragangliomas. With the adoption of a multimodality diagnostic approach (MRI, FDG PET/CT, SSTR PET/CT, and I-131 MIBG scintigraphy), a holistic theranostic approach was employed with the most rational therapeutic option offered to the patient.

P1, N=44, Active, not recruiting, University Hospital Southampton NHS Foundation Trust | Trial completion date: Nov 2025 --> Sep 2026

P2, N=200, Recruiting, Memorial Sloan Kettering Cancer Center | Trial completion date: May 2026 --> May 2027 | Trial primary completion date: May 2026 --> May 2027

We hypothesize that the GH and TSH deficiency in this case are caused by pituitary damage through binding of [ 177 Lu]Lu-DOTATATE to the somatostatin receptors in the pituitary gland. If [ 177 Lu]Lu-DOTATATE in the future becomes a more upfront treatment we strongly underline screening on pituitary dysfunction after exposure to [ 177 Lu]Lu-DOTATATE in childhood.

P1, N=99, Completed, Children's Oncology Group | Active, not recruiting --> Completed | Trial completion date: Sep 2025 --> Dec 2025

177Lu-therapies are restricted to 7 countries, and the availability of [131I]MIBG remains limited...Sustained investment in facilities, training, and regulatory frameworks is essential to achieve equitable access to care. IAEA's regional anchor centers as part of the Rays of Hope initiative exemplifies strategic capacity building, collaboration, and knowledge sharing in the region.

P2, N=118, Not yet recruiting, New Approaches to Neuroblastoma Therapy Consortium

Radiopharmaceuticals such as 131I-MIBG and 177Lu-DOTATATE continue to play a pivotal role, achieving disease control in many patients. Cytotoxic regimens, particularly temozolomide, remain relevant, with some studies suggesting that SDHB-mutated PPGLs demonstrate a heightened sensitivity associated with MGMT promoter hypermethylation and reduced MGMT expression. Targeted agents are increasingly important: multi-kinase inhibitors such as sunitinib, anlotinib, and cabozantinib have shown meaningful activity. The landmark approval of belzutifan, a HIF-2α inhibitor, in 2025 represents the first oral targeted therapy for advanced/metastatic PPGL, which is particularly relevant for pseudohypoxic Cluster 1 tumors...This review summarizes current evidence and highlights ongoing clinical trials, underscoring a paradigm shift toward precision medicine and rational combination strategies. Collectively, these advances bring cautious optimism that metastatic PPGLs may soon become a more manageable chronic disease with improved survival and quality of life.

This study aims to investigate the therapeutic potential of 131I-MIBG and the PARP inhibitor fluzoparib monotherapies and their combination on two distinct PC12-derived stable cell lines: PC12-NET cells and PC12-NET-SDHB cells...The specificity of PC12-NET cells to the 131I-MIBG was confirmed through desipramine inhibition assays...The combined of 131I-MIBG with PARP inhibitor demonstrated a synergistic antitumor effect in PC12-NET cells. While PC12-NET-SDHB cells display comparable sensitivity to 131I-MIBG as PC12-NET cells, they exhibited heightened responsiveness to PARP inhibitor treatment.

P=N/A, N=15, Completed, Masonic Cancer Center, University of Minnesota | Suspended --> Completed | N=100 --> 15

This study highlights the critical influence of the compounds' chemical structure on NET and OCT affinities. Structural modifications that reduce OCT-mediated uptake while maintaining high NET affinity could improve the specificity and theranostic potential of NET-targeting ligands. These findings provide insights for designing next-generation radiotracers with enhanced selectivity and clinical utility.

P1, N=44, Active, not recruiting, University Hospital Southampton NHS Foundation Trust | Trial completion date: Jul 2025 --> Nov 2025