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Immunotherapy for pediatric solid tumors: overcoming biological barriers through rational multimodal combinations - PubMed

5 hours ago
  • #Pediatric Oncology
  • #Solid Tumors
  • #Immunotherapy
  • Immunotherapy for pediatric solid tumors faces challenges like low tumor mutational burden, sparse neoantigens, and immunosuppressive microenvironments.
  • Anti-GD2 monoclonal antibodies have improved survival in high-risk neuroblastoma, with antibody-drug conjugates and bispecific T cell engagers targeting GD2, B7-H3, and GPC2 expanding applications.
  • CAR T cell therapies show feasibility with advanced engineering strategies, including cytokine armoring and bispecific constructs, to overcome barriers like poor tumor infiltration and antigen escape.
  • Immune checkpoint inhibitors are ineffective as monotherapy in unselected populations but induce durable responses in subsets like mismatch repair-deficient and hypermutated tumors.
  • Emerging platforms, such as oncolytic virotherapy, NK cell engagers, and neoantigen vaccines, aim to convert immunologically cold tumors into treatment-responsive phenotypes, pointing toward future combination immunotherapy tailored to pediatric cancers.