Targeted immune activation in pediatric solid tumors: opportunities to complement local control approaches

Area of Science:

• Pediatric Oncology
• Cancer Immunology
• Surgical Oncology

Background:

• Surgery and radiation are standard treatments for pediatric solid tumors.
• Distant metastatic disease often evades local treatments, impacting patient outcomes.
• Local therapies can suppress systemic anti-tumor immunity, potentially promoting tumor growth.

Purpose of the Study:

• To review the tumor immune microenvironment in common pediatric solid tumors.
• To examine immune responses to surgery and radiation therapy.
• To explore therapeutic modulation of perioperative immunity to improve outcomes for metastatic disease.

Main Methods:

• Literature review of tumor immunology and perioperative immune responses.
• Analysis of current evidence on immune-activating agents in the perioperative window.
• Identification of knowledge gaps in translational research.

Main Results:

• Local control of pediatric solid tumors can induce systemic immunosuppression.
• Perioperative immune modulation offers a potential strategy to enhance anti-tumor immunity.
• Evidence supports the use of immune-activating agents during the perioperative period.

Conclusions:

• Understanding tumor immunology and perioperative responses is crucial for therapeutic modulation.
• Targeting perioperative immunity may prevent local treatments from becoming pro-tumorigenic.
• Further research is needed to bridge knowledge gaps and advance translational applications.