Pediatric cancer patients with an aggressive form of neuroblastoma can now receive an innovative therapy at Cohen Children’s Medical Center that can add precious time to their lives. Cohen is one of only a handful of hospitals nationwide, and one of the only hospitals in the tri-state area, to offer the treatment.
The therapy uses a compound, metaiodobenzylguanidine (MIBG), which contains radioactive iodine that is delivered intravenously to destroy neuroblastoma cells.
In order to provide the therapy, Cohen had to invest upward of $1 million – largely funded through philanthropy – for specialized equipment, staff training, and a customized lead-walled treatment room to protect patients in adjacent rooms and staff from radiation exposure.
“The children who are treated with MIBG actually become radioactive. You’re injecting the patient with a radioactive substance that then makes the patient emit radiation,” said Jonathan Fish, MD, a pediatric oncologist/hematologist at Cohen.
“This is different than conventional radiation therapy for cancer, which involves creating a high-energy radiation beam that’s targeting the cancer, but the patient does not become radioactive,” explained Dr. Fish.
Neuroblastoma is an aggressive childhood cancer that arises from the sympathetic nervous system – a part of the nervous system responsible for accelerating the heart rate, constricting blood vessels, and raising blood pressure when the body is stressed.
“One of the most common places to develop a neuroblastoma is in your adrenal glands, that’s the gland that sits like a hat on top of the kidneys and one of its functions is to make adrenaline,” said Dr. Fish.
The administration of MIBG is done in one dose that takes a matter of minutes. However, patients must remain in the lead-walled treatment room between three to seven days until they are at a safe radiation level and can’t harm anyone they come in contact with.
Parents can visit with their child in the room during this time, but they must stay behind a lead shield and wear a monitor to track how much radiation they are exposed to. An adjoining anteroom is equipped with two-way audio and visual communication so parents can interact with their child while staying safe from radiation.
MIBG is used when neuroblastoma patients have relapses or are not responding to other treatments such as chemotherapy. Most conventional treatment cures between 50 to 60 percent of neuroblastoma patients.
“In the context of a child who has high-risk neuroblastoma that has relapsed or is unresponsive, then the MIBG can extend a high-quality of life for months or years,” said Dr. Fish.
Nationally, researchers are very close to incorporating high-dose MIBG as part of first-line treatment for newly diagnosed patients, explained Dr. Fish, with the goal of improving cure rate.
The MIBG program at Cohen Children’s was made possible in part by the Kostaris family of Queens, who lost their young daughter Anastasia to neuroblastoma. As part of her treatment, Anastasia traveled out of state for MIBG therapy. To help local children who need the advanced treatment, the Kostarises founded Anastasia’s Legacy to fast-track the creation of an MIBG program within Cohen Children's Division of Pediatric Hematology/Oncology and Stem Cell Transplantation.
About Cohen Children’s Medical Center
Founded in 1983, Cohen Children’s Medical Center is a 202-bed hospital dedicated exclusively to the care of children. The specialists in the hospital’s national and international programs cover an entire range of specialties. State-of-the-art care for children’s medical, surgical, and dental needs are provided in both inpatient and outpatient settings. The facility is the largest provider of pediatric health services in New York State, serving 1.8 million children in Brooklyn, Queens, and Nassau and Suffolk Counties. For the 11th consecutive year in 2017, Cohen’s was ranked among the nation’s best children’s hospitals in U.S. News & World Report's 2017-18 “America’s Best Children’s Hospitals” survey, achieving top-50 rankings in nine of 10 pediatric specialties.