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Review
. 2018 Oct;20(5):395-408.
doi: 10.1007/s40272-018-0297-x.

Pediatric Cancer Immunotherapy: Opportunities and Challenges

Mary Frances Wedekind  1   2 , Nicholas L Denton  2 , Chun-Yu Chen  2 , Timothy P Cripe  3   4
Affiliations
Review

Pediatric Cancer Immunotherapy: Opportunities and Challenges

Mary Frances Wedekind et al. Paediatr Drugs. 2018 Oct.

Abstract

Cancer immunotherapies, widely heralded as transformational for many adult cancer patients, are becoming viable options for selected subsets of pediatric cancer patients. Many therapies are currently being investigated, from immunomodulatory agents to adoptive cell therapy, bispecific T-cell engagers, oncolytic virotherapy, and checkpoint inhibition. One of the most exciting immunotherapies recently FDA approved is the use of CD19 chimeric antigen receptor T cells for pre-B-cell acute lymphoblastic leukemia. With this approval and others, immunotherapy for pediatric cancers is gaining traction. One of the caveats to many of these immunotherapies is the challenge of predictive biomarkers; determining which patients will respond to a given therapy is not yet possible. Much research is being focused on which biomarkers will be predictive and prognostic for these patients. Despite many benefits of immunotherapy, including less long-term side effects, some treatments are fraught with immediate side effects that range from mild to severe, although most are manageable. With few downsides and the potential for disease cures, immunotherapy in the pediatric population has the potential to move to the front-line of therapeutic options.

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Conflict of interest statement

Mary Frances Wedekind, Nick Denton, Chun-Yu Chen, and Timothy Cripe declare that they have no conflicts of interest that might be relevant to the contents of this manuscript.

Figures

Fig. 1
Fig. 1
Mechanism of immune evasion via immunoediting, with its three phases: elimination, equilibrium, and escape. MDSC myeloid-derived stem cell, Treg T-regulatory cell
Fig. 2
Fig. 2
Immunotherapies for pediatric cancers. a Immunomodulatory treatments. b Antibody therapy. IFN interferon, IL interleukin, L-MTP-PE liposomal muramyl tripeptide phosphatidylethanolamine, NK natural killer cell, BiTE bispecific T-cell engager antibody
Fig. 3
Fig. 3
Immunotherapies for pediatric cancers. a Oncolytic virotherapy. b Adoptive therapy. c Checkpoint inhibition. See Fig. 1 for definition of cell types. CAR-T chimeric antigen receptor T cells, CTLA-4 cytotoxic T lymphocyte associated protein 4, DAMPs damage-associated molecular signals, LAG-3 Lymphocyte activation gene 3, MHC major histocompatibility complex, PAMPs pathogen-associated molecular signals, PD-L1 Programmed death ligand 1, PD-1 Programmed death receptor 1, TIM-3 T-cell immunoglobulin and mucin domain containing 3
See this image and copyright information in PMC

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