Background: Despite the significant improvement of survival outcomes in childhood cancers
over the last four decades, the decline of mortality has slowed down and the intensity of using
chemotherapeutic combinations has reached maximum tolerable level. To further improve outcomes,
there has been increasing focus on immunotherapy.
Objective: We will review the various immunotherapeutic options for pediatric malignancies, with their
current issues, and assess future directions for the field.
Methods: Literature review of the field of immunology and immunotherapies for pediatric and adult
Results: Monoclonal antibodies and chimeric antigen receptor (CAR) T cell therapies are demonstrating
promising clinical activity but there are lags in development and clinical application of other specific
immunotherapies for pediatric patients.
Conclusion: The robust immunological responsiveness of pediatric patients constitutes a unique
opportunity for maximum therapeutic impact but additional investigation needs to be directed toward
further understanding the operational mechanisms of immune suppression in pediatric tumors and
alternative approaches for antigenically bland tumors.