Kristopher Bosse, MD, attending physician, Division of Oncology, The Children's Hospital of Philadelphia, discusses the use of immunotherapy in the treatment of pediatric patients with cancer.

Immunotherapy has garnered a lot of interest in both pediatric and adult cancers, but antibody-based therapy is a particular area of interest in pediatric cancers, says Bosse. This may include antibody-drug conjugates (ADCs), chimeric antigen receptor (CAR) T-cell therapy, or bispecific antibodies that target differentially expressed molecules, explains Bosse. Physicians are learning that there are a lot of molecules that have yet to be discovered.

The ADC that targets the GPC2 molecule is one of the first molecules to be discovered and linked to promising preclinical data. This is likely just the tip of the iceberg, explains Bosse. The hard part, explains Bosse, comes in developing appropriate therapies for these molecules. Through further research, physicians may uncover that ADCs are more appropriate for solid tumors or even CAR T cells, but there is still a lot to learn.

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Dr. Bosse on Immunotherapy in Pediatric Cancers

Kristopher Bosse, MD, attending physician, Division of Oncology, The Children's Hospital of Philadelphia, discusses challenges with immunotherapy in pediatric cancers.

Bosse says that choosing the correct immunotherapy for pediatric patients with solid tumors is a challenge. There are some immunotherapies in the pipeline being developed to target certain molecules in neuroblastoma, but finding targets has proven difficult.

As a result of the success of chimeric antigen receptor T-cell therapy, CD19 has become the gold standard, Bosse says. There are very few other molecules like that on pediatric cancers, posing a challenge in developing new cellular therapies and immunotherapeutics.

Cancers are very apt to developing resistance mechanisms to potent therapies by losing antigens or switching lineage, which can allow them to hide, Bosse explains. Combination therapies, or dual-targeting immunotherapeutics may be an approach to overcome this, he suggests.

Kristopher Bosse, MD, attending physician, Division of Oncology, The Children's Hospital of Philadelphia, discusses challenges with immunotherapy in pediatric cancers.
 

Dr. Bosse on Challenges With Immunotherapy in Pediatric Cancers

Kristopher Bosse, MD, attending physician, Division of Oncology, The Children's Hospital of Philadelphia, discusses the treatment of pediatric patients with high-risk neuroblastoma.

The standard therapy for pediatric patients with high-risk neuroblastoma is approximately 1 to 2 years of chemotherapy, surgery, radiation, and transplant. In the last few years, immunotherapy has entered the treatment landscape with the approval of dinutuximab (Unituxin) in combination with interleukin-2, GM-CSF, and isotretinoin as a frontline therapy for pediatric patients with high-risk neuroblastoma who responded to prior induction therapy.

Bosse says that there is still work to do, as patients must deal with a very long, complicated, and painful treatment regimen. Only about half of pediatric patients with neuroblastoma are cured on the currently available treatments, and most live the rest of their lives dealing with the side effects from their therapy.

Kristopher Bosse, MD

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Dr. Bosse on Immunotherapy in Pediatric Cancers

Dr. Bosse on Challenges With Immunotherapy in Pediatric Cancers

Dr. Bosse on the Treatment of Neuroblastoma in Pediatric Patients