Patient-derived organoid in vitro models for antibody-based immunotherapy in pediatric solid tumors

Pediatric solid tumors remain a leading cause of cancer-related deaths in children, and outcomes for metastatic or relapsed disease continue to be poor despite multimodal treatment. Antibody-based immunotherapies show promise with the potential for greater specificity and fewer side effects. However, their development is hindered by preclinical models that do not accurately represent tumor heterogeneity or the pediatric tumor microenvironment. Patient-derived organoids (PDOs) have emerged as physiologically relevant models that maintain the histological, genetic, and functional features of primary tumors. This review covers current methods for creating pediatric tumor PDOs and highlights their applications in molecular analysis, drug testing, and personalized cancer treatment. It also examines the growing application of PDO platforms in evaluating antibody-based immunotherapies. Finally, we discuss advancements in immune-integrated organoid systems and the ongoing challenges, emphasizing the potential of PDOs to accelerate the development of immunotherapies for pediatric solid tumors.