Harnessing the Immune System to Fight Pediatric Cancer—Second Edition

Dear Colleagues,

Pediatric cancer presents unique treatment challenges as well as opportunities. Current treatment strategies typically involve the use of highly toxic drugs, which can result in life-long side effects. Treatment failure and relapse lead to increasingly worse outcomes and side effects from increasingly toxic therapies. Despite some striking progress, particularly against certain B cell hematological malignancies, pediatric cancers typically lack the large number of mutations that make immunotherapy options effective. Genomic medicine offers the opportunity to identify genetic and, perhaps more importantly, epigenetic changes that might be targeted by molecular and immune-based therapies. This Special Issue will review how the genomes and epigenomes of pediatric patients are unique and potentially targetable. Recently, cutting-edge advances include efforts to prevent the exhaustion of anti-cancer T cells, particularly those expressing chimeric antigen receptors (CARs) targeting tumor cells. Related investigations include research on enigmatic populations of stem-like T cells. CRISPR has also become a powerful tool for genome-wide screens and can be used to achieve an unprecedented level of highly specific genetic manipulation. New immune checkpoints and corresponding inhibitors are being discovered, and advances in bispecific antibodies and CAR constructs are being explored to prevent treatment failure. Furthermore, the tumor microenvironment, characterized as immunologically “hot” or “cold”, is being deciphered to better employ these immunotherapies or (re)activate endogenous immunotherapies. Identifying rare genetic and epigenetic variants that contribute to pediatric cancer using these new tools and concepts will lead to new treatment options for this vulnerable population.

Dr. John M. Perry
Guest Editor

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• immunotherapy
• pediatric cancer
• CAR T cells
• immune checkpoint inhibitors
• tumor microenvironment
• therapy resistance
• targeted therapy
• adoptive cell transfer
• stem-like T cells
• bispecific antibodies
• cancer vaccines