Nothing but NET: A review of norepinephrine transporter expression and efficacy of 131I-mIBG therapy

Neuroblastoma is unique amongst common pediatric cancers for its expression of the norepinephrine transporter (NET), enabling tumor‐selective imaging and therapy with radioactive analogues of norepinephrine. The majority of neuroblastoma tumors are avid for 123I‐metaiodobenzaguanidine (mIBG) on imag...

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Bibliographic Details
Published in:Pediatric blood & cancer 2015-01, Vol.62 (1), p.5-11
Main Authors: Streby, Keri A., Shah, Nilay, Ranalli, Mark A., Kunkler, Anne, Cripe, Timothy P.
Format: Article
Language:English
Subjects:
3-Iodobenzylguanidine - therapeutic use
Hematology
Humans
Iodine Radioisotopes - therapeutic use
meta-iodobenzylguanidine
neuroblastoma
Neuroblastoma - metabolism
Neuroblastoma - pathology
Neuroblastoma - radiotherapy
Norepinephrine Plasma Membrane Transport Proteins - metabolism
norepinephrine transporter
Oncology
Pediatrics
Prognosis
Radiopharmaceuticals - therapeutic use
Review
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Summary:Neuroblastoma is unique amongst common pediatric cancers for its expression of the norepinephrine transporter (NET), enabling tumor‐selective imaging and therapy with radioactive analogues of norepinephrine. The majority of neuroblastoma tumors are avid for 123I‐metaiodobenzaguanidine (mIBG) on imaging, yet the therapeutic response to 131I‐mIBG is only 30% in clinical trials, and off‐target effects cause short‐ and long‐term morbidity. We review the contemporary understanding of the tumor‐selective uptake, retention, and efflux of meta‐iodobenzylguanidine (mIBG) and strategies currently in development for improving its efficacy. Combination treatment strategies aimed at enhancing NET are likely necessary to reach the full potential of 131I‐mIBG therapy. Pediatr Blood Cancer 2015;62:5–11 © 2014 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals, Inc.
ISSN:1545-5009
1545-5017
DOI:10.1002/pbc.25200