MOLECULAR MECHANISMS AND CLINICAL POSSIBILITIES OF IMMUNOTHERAPY FOR NEUROBLASTOMA IN CHILDREN

Abstract

The review examines the current state of immunotherapy for high-risk neuroblastoma and other GD2-positive tumors in children against the background of persistent limitations of standard multimodal treatment and a high relapse rate. Particular attention is paid to practical issues of selecting a therapeutic platform and managing patients, since treatment tolerability and feasibility often determine the actual clinical effect. It is shown that the inclusion of anti-GD2 therapy in maintenance and relapse protocols is associated with improved survival outcomes; however, it is accompanied by a typical toxicity profile, including neuropathic pain, fever, hypersensitivity reactions, capillary leak syndrome, and infectious complications, which often affects treatment completion and requires protocol-based supportive care. The prospects for expanding indications and developing GD2-CAR-T/CAR-NK/NKT platforms are discussed separately, along with the significance of response biomarkers, including GD2 expression, effector immune parameters, and FCGR variants, as a basis for more accurate patient stratification and optimization of therapeutic strategies.