A Review of Neuroblastoma Treatment with a Focus on CAR T-Cell Therapy

Neuroblastoma (NB) is a deadly disease that afflicts at least 700 U.S. children every year, most of which are under five years old. Complex and difficult to detect, NB treatment presents a number of challenges. The immunosuppressive tumor microenvironment (TME), difficulty in trafficking to tumor sites, exhaustion of CAR T cells, and adverse effects such as Cytokine Release Syndrome (CRS) and on-target off-tumor toxicity are all major issues that scientists face when applying CAR T-cell therapy. With current limitations, CAR T therapies for NB need further exploration. For example, the abilities of different antigens need to be compared. Also, differences between immune cells such as cytotoxic T cells versus NKT cells should be explored. Additionally, relatively unexplored forms of treatment such as autophagy and YAP inhibition show promise. This review discusses the origin and background of neuroblastoma, a solid tumor cancer arising from the sympathetic nervous system. Treatment of this disease is still relatively novel and needs further development. This paper describes the work done in this field thus far and also discusses potential future treatment strategies. With future study, the foundation of cancer immunotherapy research that has been laid will undoubtedly lead to improvement in CAR T-cell therapy and NB treatment.