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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  123 I‐metaiodobenzaguanidine (mIBG) on imaging, yet the therapeutic response to  131 I‐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  131 I‐mIBG therapy. Pediatr Blood Cancer 2015;62:5–11 © 2014 The Authors.  Pediatric Blood & Cancer  published by Wiley Periodicals, Inc.

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