For children diagnosed with rare, high-risk neuroblastoma, MIBG therapy may be a treatment option. Neuroblastoma is an aggressive cancer of the nerve cells that spreads quickly and typically affects children younger than 5. Standard treatment options for neuroblastoma include surgery to remove the tumor, external radiation therapy, chemotherapy, bone marrow transplant and immunotherapy. 

Iodine-131 metaiodobenzylguanidine (I-131 MIBG) therapy is designed specifically to treat children with high-risk neuroblastomas using an investigational drug – a radiopharmaceutical that delivers targeted radiation directly to tumor cells. 

Lead-lined roomBecause of the high levels of radiation, MIBG therapy must be administered in a specially-designed lead-lined room.  Siteman Kids’ lead-lined therapy suite is one of only 20 dedicated to children in the country and the only one of its kind in Missouri and within 300 miles of St. Louis

The I-131 MIBG therapy is recommended for patients age 12 months or older.

What to expect

MIBG therapy is delivered in a specially-designed lead-lined therapy suite.  This 275-square-foot hospital room includes a lead-lined patient room and an adjacent, hotel-like, private room so family members can stay close while being protected from radiation exposure. There is also an entry area where doctors and nurses can safely prepare to enter the patient room to care for the child.

Your child will be admitted to the hospital 24 hours before therapy begins.  He or she will get acquainted with the MIBG therapy suite and meet their nurses and medical care team.  

A nurse//brachytherapist will give the MIBG treatment through an intravenous, or IV, line.  Your child will receive the medication more than two hours.

Once the treatment is given, MIBG goes to neuroblastoma tumors and delivers its radiation. Children receiving the therapy need to stay in the special lead-lined room during treatment and for three to six days afterward, until most of the radiation has left their body. 

MIBG lead-lined roomThe lead-lined suite is designed so staff can care for your child safely and parents can stay near their child during and after treatment. The patient room and adjacent private room for families includes a lead-lined window so everyone can see each other. Both rooms include a bathroom with a shower, two-way audio and visual communication and televisions. 
Your child’s care team

Cancer care can be stressful for the entire family, so St. Louis Children’s Hospital provides additional support prior to and during a child’s hospitalization, which includes meeting with a child life specialist and social workers.

How does MIBG therapy work?

Certain types of nerve tissues absorb MIBG, including some neuroblastoma cells.  When MIBG is combined with I-131, a radioactive iodine, it can deliver targeted radiation to the neuroblastoma. After preliminary studies of I-131 MIBG therapy by various institutions, using MIBG therapy for patients with relapsed or refractory high-risk neuroblastoma, the Children’s Oncology Group began a clinical trial that adds I-131 MIBG therapy to the conventional treatments prescribed for children with newly diagnosed high-risk neuroblastoma. Promising outcomes led to the expanded study in which Children’s Hospital and the School of Medicine are participating.

The MIBG therapy suite was made possible thanks to generous donors to St. Louis Children’s Hospital.