The immune landscape of solid pediatric tumors


The immune landscape of solid pediatric tumors


Shimaa Sherif
Jessica Roelands
William Mifsud
Eiman I Ahmed
Christophe M Raynaud
Darawan Rinchai
Abbirami Sathappan
Ata Maaz
Ayman Saleh
Erdener Ozer
Khalid A Fakhro
Borbala Mifsud
Vésteinn Thorsson
Davide Bedognetti
Wouter R L Hendrickx




Background: Large immunogenomic analyses have demonstrated the prognostic role of the functional orientation of the tumor microenvironment in adult solid tumors, this variable has been poorly explored in the pediatric counterpart.

Methods: We performed a systematic analysis of public RNAseq data (TARGET) for five pediatric tumor types (408 patients): Wilms tumor (WLM), neuroblastoma (NBL), osteosarcoma (OS), clear cell sarcoma of the kidney (CCSK) and rhabdoid tumor of the kidney (RT). We assessed the performance of the Immunologic Constant of Rejection (ICR), which captures an active Th1/cytotoxic response. We also performed gene set enrichment analysis (ssGSEA) and clustered more than 100 well characterized immune traits to define immune subtypes and compared their outcome.

Results: A higher ICR score was associated with better survival in OS and high risk NBL without MYCN amplification but with poorer survival in WLM. Clustering of immune traits revealed the same five principal modules previously described in adult tumors (TCGA). These modules divided pediatric patients into six immune subtypes (S1-S6) with distinct survival outcomes. The S2 cluster showed the best overall survival, characterized by low enrichment of the wound healing signature, high Th1, and low Th2 infiltration, while the reverse was observed in S4. Upregulation of the WNT/Beta-catenin pathway was associated with unfavorable outcomes and decreased T-cell infiltration in OS.

Conclusions: We demonstrated that extracranial pediatric tumors could be classified according to their immune disposition, unveiling similarities with adults' tumors. Immunological parameters might be explored to refine diagnostic and prognostic biomarkers and to identify potential immune-responsive tumors.


J Exp Clin Cancer Res
. 2022 Jun 11;41(1):199. doi: 10.1186/s13046-022-02397-z.




Shimaa Sherif et al., “The immune landscape of solid pediatric tumors,” NEOMED Bibliography Database, accessed July 19, 2024,