Combiningthe advancements in genetic engineering technologies and the
principle knowledge of cancer immunology, chimeric antigen receptor (CAR) T cell
therapy has emerged as a promising therapeutic modality for cancers. The function of
CARs is to redirect the immune response to attack cancer cells in a specific manner. Up
to date, multiple CAR configurations have been designed to ensure safety and to
enhance in vivo persistence and therapeutic potency. A number of clinical trials of
CAR T therapy for pediatric solid tumors are underway, mainly focusing on
neuroblastoma patients. Although CAR T therapy has been approved by the US Food
and Drug Administration (FDA) for hematological malignancies, disappointing
response rates have been reported in solid cancers due to several hindrances. Proper
target antigen selection, inefficient T cell trafficking, and the immunosuppressive
nature of the tumor microenvironment (TME) are the main factors limiting CAR T
function. In order for CAR T therapy to become successful in this matter, these
challenges must be addressed. The future of CAR T therapy is moving toward the
development of the “off-the-shelf” universal CAR T product in the hope of providing cancer treatment to a large population. This chapter reviews the principles of CAR
design, current clinical trials, limitations, and future prospects of CAR T cells for
pediatric solid tumors.
Keywords: CAR T Cells, Immunotherapy, Pediatric Solid Malignancies.
