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Children's Immune Response to Cancer Differs From Adults

Cancer cells.
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Researchers at Karolinska Institutet and the Astrid Lindgren Children’s Hospital in Sweden have found that children’s immune systems respond differently to cancer than those of adults. The study, published in Cell, analyzed the immune responses of 191 children aged 0 to 18 diagnosed with solid tumors. Findings from this research may guide the development of tailored immunotherapies for pediatric cancer patients.

Age-related differences in immune responses

The study identified variations in how children’s and adults’ immune systems react to cancer. Compared to adults, children’s tumors generally exhibit fewer genetic mutations and appear less inflammatory. This may cause the immune system to recognize these tumors as less foreign, leading to a weaker immune response.

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The research team also observed large individual differences in immune activation among children. These findings emphasize the need for personalized treatment approaches, which could adapt therapies to the specific immune characteristics of individual patients.

Expanding precision medicine to include immune profiling

The researchers collected and analyzed tumor tissue and blood samples to map genetic mutations in tumors and evaluate immune system activity. While precision medicine has traditionally focused on tumor-specific characteristics, this study introduces immune system profiling as a complementary dimension. By understanding how pediatric immune systems react to cancer, clinicians may identify more effective therapeutic strategies for children.

Precision medicine

An approach to medical treatment that tailors therapies to individual patients based on their unique genetic, environmental, and lifestyle factors.

Implications for immunotherapy in children

Immunotherapies, including checkpoint inhibitors that target immune cell deactivation pathways, have shown limited efficacy in pediatric cancer. The study suggests this may be because children’s immune systems are often not initially activated against tumors. Future pediatric immunotherapies may need to focus on stimulating immune cells from the outset to target cancer cells effectively.


The research also tracked changes in populations of killer T cells, which are key to destroying tumor cells, during treatment. This tracking could help assess treatment efficacy and enable real-time adjustments to therapy.

Checkpoint inhibitors

A type of immunotherapy that blocks proteins on immune cells that prevent them from attacking tumors, making these cells more effective in targeting cancer.

Killer T cells

A subtype of immune cells that can identify and destroy cancerous or infected cells in the body.

Future directions and clinical applications

This research highlights the potential for integrating immune profiling into routine clinical care for pediatric cancer. Researchers plan to expand these findings to larger studies, aiming to refine treatment strategies further. Tracking immune responses could complement existing genetic analyses of tumors, offering a more comprehensive understanding of each patient’s cancer biology.


Reference: Chen Q, Zhao B, Tan Z, et al. Systems-level immunomonitoring in children with solid tumors to enable precision medicine. Cell. doi: 10.1016/j.cell.2024.12.014


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