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Modulation of radiation biomarkers in a randomized phase II study of 131I-MIBG with or without radiation sensitizers for relapsed or refractory neuroblastoma

ABSTRACT: Modulation of radiation biomarkers in a randomized phase II study of 131I-MIBG with or without radiation sensitizers for relapsed or refractory neuroblastoma

PROVIDER: PRJNA846720 | ENA |

REPOSITORIES: ENA

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			Action	DRS
	SRR19572900.fastq.gz	Fastqsanger.gz
	SRR19572901.fastq.gz	Fastqsanger.gz
	SRR19572902.fastq.gz	Fastqsanger.gz
	SRR19572903.fastq.gz	Fastqsanger.gz
	SRR19572904.fastq.gz	Fastqsanger.gz

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Modulation of radiation biomarkers in a randomized phase II study of 131I-MIBG with or without radiation sensitizers for relapsed or refractory neuroblastoma

Project description:Background 131I-metaiodobenzylguanidine (131I-MIBG) has demonstrated efficacy as a single agent in neuroblastoma. Recent trials have focused on 131I-MIBG combination strategies, though little is known about the impact of combination agents on markers of radiation exposure. Methods Trial NANT11-01 (NCT02035137) evaluated 131I-MIBG therapy alone (Arm A) or in combination with vincristine/irinotecan (Arm B) or vorinostat (Arm C) for patients with relapsed or refractory neuroblastoma. We collected blood samples before and after 131I-MIBG infusion and determined levels of radiation-associated biomarkers. We evaluated marker association with treatment arm, clinical response, and toxicity. Results The cohort included 99 patients who had at least one biomarker available for analysis. We observed significant modulation in most biomarkers between baseline, 72 hours, and 96 hours following 131I-MIBG. Patients in Arm C had the lowest degree of modulation in FLT3 ligand. Lower baseline BCL2 levels were associated with higher overall response. Patients with greater increases in FLT3 ligand at 96 hours after 131I-MIBG therapy were significantly more likely to have grade 4 thrombocytopenia. Peripheral blood gene expression of the BCL2 family of apoptotic markers (BCL2/L1 and BAX) was significantly associated with grade 4 hematologic toxicity. RNA sequencing demonstrated little overlap in the top modulated peripheral blood transcripts between randomized arms. Conclusions Peripheral blood biomarkers relevant to radiation exposure demonstrate significant modulation after 131I-MIBG and concomitant radiation sensitizers impact extent of modulation. Biomarkers related to hematopoietic damage and apoptosis were associated with hematologic toxicity.

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