Despite the success of immunotherapies in adult solid cancers and pediatric hematological malignancies, limited progress has been made towards implementing these strategies in pediatric solid tumors. These tumors exhibit a high potential to escape antitumor immunity, making them difficult to target by current immunotherapies. This review highlights the altered metabolic pathways in pediatric solid tumors that promote immune escape, and discusses current novel strategies targeting these pathways. We further explore how these strategies could be applied to potentiate immunotherapies for pediatric solid cancers and pose key questions yet to be addressed. Translational challenges to facilitate clinical application of antimetabolic strategies through personalized medicine are identified. We propose preclinical testing of antimetabolic approaches in combination with immunotherapies for pediatric solid cancers.

尽管免疫疗法在成人实体癌和小儿血液系统恶性肿瘤中取得了成功，但在儿童实体瘤中实施这些策略方面取得的进展有限。这些肿瘤表现出逃避抗肿瘤免疫的高潜力，使它们难以被当前的免疫疗法靶向。本综述重点介绍了促进免疫逃逸的儿科实体瘤代谢途径的改变，并讨论了当前针对这些途径的新策略。我们进一步探索如何将这些策略应用于增强小儿实体癌的免疫疗法，并提出有待解决的关键问题。确定了通过个性化医疗促进抗代谢策略临床应用的转化挑战。