Work

Optimizing the Efficacy–Toxicity Paradigm in Pediatric Oncology: A Narrative Review of Immunotherapy and Survivorship Outcomes

Year: 2026

Type: review

Abstract: BACKGROUND: Childhood cancer survival now approaches 80% in high-income countries, yet most survivors face lifelong toxicity. This review examines the interplay between treatment efficacy, relapse prevention, and therapy-related complications. METHODS: Narrative synthesis of landmark pediatric oncology trials (2000-2026), including AALL1731 (blinatumomab), ELIANA/PLAT-02 (CAR T-cell), and GD2-CART01 (neuroblastoma), with comparative analysis of efficacy and toxicity. RESULTS: < 0.001), but increased sepsis from 5.1% to 14.8%. Comparison between AALL1731 (front-line blinatumomab) and ELIANA (CAR T-cell in relapsed disease) reveals that earlier immunotherapy deployment yields better outcomes: 96% DFS vs. 48% 3-year EFS, respectively. In GD2-CART01, early use (after 1-2 prior lines) achieved 89% 5-year survival vs. 43% with delayed use (HR = 0.31). Approximately 95% of survivors experience ≥1 late effect, with 60-90% carrying chronic conditions into adulthood. CONCLUSIONS: Immunotherapy transforms outcomes, but timing is critical, as earlier deployment dramatically improves survival. Toxicity remains pervasive, requiring systematic mitigation strategies.

Source: Current Oncology

DOI: 10.3390/curroncol33050298

Authors: Zaure Dushimova, Timur Saliev, Aigul Bazarbayeva, Kymbat Karimova, Abay Kussainov, Ildar Fakhradiyev

Institutions: Al-Farabi Kazakh National University, Kazakh National Medical University, Korea University

Language: English

Topic: CAR-T cell therapy research

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,654