Professor Boris V. Afanasyev, Editor-in-Chief, Cellular Therapy and Transplantation Journal
Dear CTT authors and readers,
Over last several years, dramatic improvement has been achieved in treatment of some malignancies in adults, and, especially, in children by means of novel agents and technologies, i.e., bi-specific T-cell engager antibodies (BITE), conjugated monoclonal antibodies, CAR-T cells, and immune checkpoint inhibitors. The above-mentioned drugs may be combined with allogeneic hematopoietic stem cell transplantation (allo-HCT), thus creating a reliable basis for sequential successful therapy.
The largest progress was attained with lymphoproliferative disorders, e.g., in patients with R/R Hodgkin lymphoma, due to introduction of Brentuximab Vedotin (BV), conjugated antibody. The immune checkpoint inhibitors have also shown high short-term efficiency, but unfortunately, the progression-free survival in these cases remains relatively low. However, combination of these drugs with subsequent allo- HCT has promising efficacy in terms of progression-free survival.
In R/R patients with acute lymphoblastic leukemia, some drugs like Blinatumomab, a BITE antibody, or conjugated antibody Inotuzumab, have yielded high response rates, being especially efficient in the patients with detectable minimal residual disease (MRD). It is still unclear what strategy should be used for MRD-negative patients and do they require further consolidation.
Novel trends in immune therapy of malignant disorders are associated with development of CAR-T cell-based therapeutic tools which may provide a more targeted effects upon specific neoantigens of the given tumor type. There are only several limited studies of CAR-T application in adults and pediatric patients. The efficiency of CAR-T cell treatment in solid tumors is yet to be established, but sufficient progress is recently observed in this area.
Transplantation aspects of pediatric malignancies treatment are also often spotlighted in Cellular Therapy and Transplantation. When compared with high treatment efficiency in acute lymphoblastic leukemia, pediatric tumors, like medulloblastoma, Ewing sarcoma and others are less sensitive to immunotherapy approaches due to different mutation burden and expression of neoantigens. These molecular mar-kers, as well as microsatellite instability could be of value when assessing the clinical risk groups. Elucidation of the optimal immunotherapy with or without transplantation in pediatric solid tumors is one of crucial agendas in pediatric oncology.
In conclusion, we are expecting from our readers original and review articles for our Journal on pediatric oncology/hematology from our potential authors from different clinics, aiming to optimize the response rate with lesser toxicity to normal tissues by using novel approaches, especially, immune therapy of pediatric malignancies, as well as the use of stem cell transplantation in nonmalignant disorders.