Immunotherapy has changed the landscape of cancer treatment by empowering the body’s own immune system to fight cancer cells. While this approach is used for both children and adults, the way it works, its effectiveness, and the challenges involved can differ significantly between age groups. Children’s immune systems are still developing, while adults often have pre-existing conditions or weakened immunity due to age or lifestyle factors. These biological differences influence how immunotherapy is designed, administered, and monitored. Understanding these differences helps ensure safer and more effective treatment outcomes tailored to each age group.
Differences in Immune System Function and Response
The immune system plays a central role in how well immunotherapy works. In children, the immune system is still maturing, making it more adaptable and responsive in certain cases. This can be advantageous when using immunotherapies like CAR T-cell therapy for childhood leukemias, which have shown exceptional success rates.
Children’s cancer cells often have fewer mutations compared to adults, making them more predictable and easier for engineered immune cells to identify.
Adults, however, may present a more complex challenge. With age, the immune system naturally weakens due to a process known as immunosenescence. Chronic conditions like diabetes, heart disease, or infections can further compromise immune function. As a result, adult cancers often have more mutations and can evade the immune system more easily.
Because of this, adult patients may require combination approaches—such as pairing immunotherapy with chemotherapy, radiation, or targeted therapy—to achieve optimum results.
Variation in Types of Cancers and Treatment Approaches
The cancers seen in children differ greatly from those found in adults. Pediatric cancers are often fast-growing and linked to genetic or developmental factors rather than lifestyle. Common cancers in children include acute lymphoblastic leukemia (ALL), neuroblastoma, and certain brain tumors. Immunotherapy in children is usually focused on blood cancers, where treatments like CAR T-cell therapy and monoclonal antibodies have shown strong success.
In contrast, adult cancers are frequently linked to long-term exposure to carcinogens, aging cells, and environmental factors. Adults typically face cancers such as lung, breast, colon, and prostate cancer—many of which respond differently to immunotherapy. Treatments like immune checkpoint inhibitors (including PD-1 and CTLA-4 blockers) are more commonly used for adult cancers because they target pathways that allow tumors to evade immune detection.
Children rarely receive checkpoint inhibitors because their cancers do not usually express the markers needed for these drugs to work effectively. Instead, pediatric immunotherapy must be carefully tailored to developmental biology to avoid long-term side effects.
Side Effects, Safety Considerations, and Long-Term Monitoring
Immunotherapy can cause side effects for both children and adults, but how these side effects appear—and how they are managed—varies with age.
In children, immunotherapy can affect organs that are still developing, raising concerns about long-term impact on growth, fertility, and cognitive development. Side effects like cytokine release syndrome (CRS) require close monitoring in a specialized care setting. Since children typically recover faster, they may respond well once complications are controlled.
Adults may experience more severe or prolonged side effects due to pre-existing health conditions. Immune-related side effects can affect the thyroid, lungs, liver, or skin. In older adults, recovery may be slower, requiring additional medications and extended follow-up care.
Long-term monitoring is essential for both groups, but especially for children, where doctors must track developmental milestones and ensure no delayed complications arise years after treatment.
Conclusion
Immunotherapy offers hope to both children and adults, but the treatment approach must be carefully adapted based on age, cancer type, and immune system strength. Children benefit from highly targeted therapies suited to their developing bodies, while adults often require broader and combined immunotherapy strategies. The goal is the same for both: to harness the power of the immune system safely and effectively.
Dr AV Cancer Institute provides the best treatment regarding this, offering advanced immunotherapy options, expert pediatric and adult oncology teams, and comprehensive care to ensure the safest and most effective outcomes for every patient.
