EC Paediatrics

Pediatric malignancies pose unique therapeutic challenges due to their distinct molecular landscapes and developmental contexts. Although precision immunotherapy guided by molecular profiling has transformed adult oncology, its clinical implementation in children remains limited by biological, translational, and systemic barriers. Molecular profiling identifies targetable alterations in 44% to 62% of pediatric tumors, yet fewer than 10% of immunotherapy trials focus on pediatric populations. Innovations such as tumor microenvironment modulation and AI-driven biomarker discovery show promise but require validation within developmental contexts. Systemic barriers, including fragmented regulatory frameworks and limited genomic literacy among clinicians, further hinder the equitable implementation of precision immunotherapy in pediatric oncology. This review summarizes recent advances in molecular profiling and immunotherapy modalities specific to pediatric cancers. Clinical and preclinical studies were analyzed to identify actionable biomarkers and persistent challenges and disparities in global access.

 Keywords: Biomarkers; Immunotherapy; Medical Oncology; Precision Medicine; Whole Genome Sequencing

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