Targeting tumor microenvironment and metastasis in children with solid tumors

Area of Science:

• Pediatric Oncology
• Cancer Immunology
• Tumor Microenvironment Biology

Background:

• The prognosis for pediatric patients with metastatic solid tumors is poor, highlighting the need for innovative therapeutic strategies.
• The pediatric tumor microenvironment (TME) presents significant challenges to the effectiveness of current treatments, including immunotherapies.

Purpose of the Study:

• To review recent advancements in characterizing the pediatric TME.
• To discuss clinical progress in targeting the immune, vascular, and stromal components of the TME in pediatric solid tumors.

Main Methods:

• Review of recent literature on TME characterization.
• Analysis of clinical data on TME-targeted therapies.

Main Results:

• Immunotherapies show limited success but optimization strategies targeting the TME are promising.
• Therapeutic targeting of the myeloid compartment and vascular endothelial growth factor (VEGF) shows potential in refractory pediatric solid tumors.
• Emerging preclinical data on stromal targeting are enhancing understanding and paving the way for future therapies.

Conclusions:

• Targeting the TME in pediatric solid tumors is a developing therapeutic opportunity.
• Rebalancing the TME through novel approaches holds optimism for improved outcomes in pediatric cancer patients.