Neuroblastoma is a peripheral nervous system tumor that almost exclusively occurs in young children. Although intensified treatment modalities have led to increased patient survival, the prognosis for patients with high-risk disease is still around 50%, signifying neuroblastoma as a leading cause of cancer-related deaths in children. Neuroblastoma is an embryonal tumor and is shaped by its origin from cells within the neural crest. Hence, neuroblastoma usually presents with a low mutational burden and is, in the majority of cases, driven by epigenetically deregulated transcription networks. The recent development of Omic techniques has given us detailed knowledge of neuroblastoma evolution, heterogeneity, and plasticity, as well as intra- and intercellular molecular communication networks within the neuroblastoma microenvironment. Here, we discuss the potential of these recent discoveries with emphasis on new treatment modalities, including immunotherapies which hold promise for better future treatment regimens.
神经母细胞瘤是一种几乎仅发生于幼儿的外周神经系统肿瘤。尽管强化治疗手段已提高患者生存率,但高危患者的预后仍维持在50%左右,使其成为儿童癌症相关死亡的主要原因。作为胚胎源性肿瘤,神经母细胞瘤起源于神经嵴细胞,因此通常具有较低的突变负荷,且多数病例由表观遗传失调的转录网络驱动。近年来组学技术的发展,使我们能够深入了解神经母细胞瘤的演化进程、异质性特征、可塑性表现,以及肿瘤微环境中的细胞内与细胞间分子通讯网络。本文重点探讨这些新发现对治疗策略的潜在影响,特别关注包括免疫疗法在内的新型治疗模式,这些进展有望为未来制定更优化的治疗方案提供新方向。
The Neuroblastoma Microenvironment, Heterogeneity and Immunotherapeutic Approaches