India’s First High-Dose MIBG Therapy for Cancer Successfully Administered

In a landmark achievement for cancer care in India, the Tata Memorial Centre's Advanced Centre for Treatment, Research and Education in Cancer (ACTREC) has successfully administered the country’s first high-dose 131I-mIBG therapy to a 17-year-old male patient suffering from relapsed neuroblastoma—a rare but aggressive cancer that predominantly affects young children. The therapy was conducted on May 5, 2025, and was followed by an autologous hematopoietic stem cell infusion on May 29, 2025. According to Dr. Sudeep Gupta, Director of Tata Memorial Centre, the patient is currently stable and doing well.

Neuroblastoma is a type of solid tumour originating in nerve tissues, typically occurring in the adrenal glands, neck, chest, or spinal cord. It is classified as high-risk when diagnosed at an advanced stage or after relapse, and often requires an intensive multi-modality treatment approach involving chemotherapy, surgery, radiotherapy, stem cell transplant, and immunotherapy. However, in India, the high cost of targeted treatments like anti-GD2 immunotherapy—a specialized form of therapy targeting cancer cells—limits their accessibility. This has led medical institutions like ACTREC to explore radioisotope-based therapies, such as high-dose mIBG (metaiodobenzylguanidine), as viable alternatives for improving outcomes in high-risk cases.

Traditionally, in India, the standard permissible dose of 131I-mIBG therapy—an advanced form of radiopharmaceutical treatment where a radioactive iodine isotope is attached to mIBG to selectively target neuroblastoma cells—is capped at 5 mCi/kg, with a maximum of 300 mCi. However, ACTREC, under special approval from the Atomic Energy Regulatory Board (AERB), administered an unprecedented supra-high dose of 800 mCi, marking the first time such a dose has been delivered in India.

Executing this complex and high-risk procedure required extensive coordination, detailed planning, and strict adherence to radiation safety protocols. The treatment was made possible through the collective efforts of specialists from the Departments of Nuclear Medicine, Paediatric Oncology, Haematological Oncology (Bone Marrow Transplant Unit), and Transfusion Medicine, with support from international experts at Memorial Sloan Kettering Cancer Centre, New York to refine the therapeutic protocol. In particular, fractionated dispensing of the radioactive dose was conducted by medical physicists, while the actual administration was done by two nuclear medicine physicians—a method that minimized radiation exposure.

Given the extreme radiation levels, the patient was managed in ACTREC’s custom-designed "hot bed" isolation ward, a specialized environment constructed to safely handle high-dose radionuclide therapies. Medical physicists and Radiation Safety Officers (RSOs) conducted simulated exposure experiments to predict and control radiation levels, while additional monitoring and shielding systems were deployed to adhere to the ALARA principle—which stands for “As Low As Reasonably Achievable”—a global safety standard aimed at minimizing radiation exposure.

As expected, following the therapy, the patient’s blood cell counts dropped, necessitating an autologous stem cell transplant, which involves reinfusing the patient’s own previously collected stem cells to help regenerate bone marrow function. This life-saving procedure was carried out on day 24 post-therapy and was successful, with the patient’s blood counts fully recovering thereafter.

This historic procedure not only opens the door for routine high-dose MIBG therapy in India but also establishes a new benchmark in the management of pediatric neuroblastoma, offering renewed hope to families and clinicians dealing with this challenging disease.

Click for Daily Current Affairs Summary

Click for Daily Quotes:

Stay updated with the latest news by joining our Telegram channel – The PRESS Pad , and follow us on Instagram and X.