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modalities can be immunomodulatory and useful for shifting the immune balance toward anti-tumor im-
munity. Advanced surgical practice, radiation, and chemotherapy, including novel, targeted agents, remain
important tools for treating our pediatric patients. It is important to point out that the most impactful treat-
ment for brain tumors in the last decade is probably not an immunotherapy; BRAF and MEK inhibitors tar-
geting the MAP kinase pathway, which is constitutively overactive in pilocytic astrocytoma and a fraction of
other glial tumors, are radically changing how these diseases are treated and improving outcomes [118] . Taken
together, the immunological context and molecular pathogenesis of each child’s tumor must be considered
on a case-by-case basis in determining any therapy, particularly in deciding what type of immunotherapy is
most likely to add benefit.

DECLARATIONS
Authors’ contributions
Design: Landi D, Ashley D
Literature research, manuscript writing, editing, and revision: Landi D, Thompson E, Ashley D

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
The authors declare that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2018.

REFERENCES
1. Ostrom QT, Gittleman H, Xu J, Kromer C, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS. CBTRUS statistical report: primary brain and
other central nervous system tumors diagnosed in the United States in 2009-2013. Neuro Oncol 2016;18:v1-75.
2. Johnson KJ, Cullen J, Barnholtz-Sloan JS, Ostrom QT, Langer CE, Turner MC, McKean-Cowdin R, Fisher JL, Lupo PJ, Partap S,
Schwartzbaum JA, Scheurer ME. Childhood brain tumor epidemiology: a brain tumor epidemiology consortium review. Cancer Epide-
miol Biomarkers Prev 2014;23:2716-36.
3. Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cro-
nin KA. SEER Cancer Statistics Review, 1975-2015. National Cancer Institute, Bethesda, MD. Based on November 2017 SEER data
submission, posted to the SEER web site on April 2018. Available from: https://seer.cancer.gov/csr/1975_2015/ 2018 [Last accessed on
18 Jul 2018].
4. Lucas MS, Barakat LP, Jones NL, Ulrich CM, Deatrick JA. Expectations for function and independence by childhood brain tumors sur-
vivors and their mothers. Narrat Inq Bioeth 2014;4:233-51.
5. van der Woude LL, Gorris MAJ, Halilovic A, Figdor CG, de Vries IJM. Migrating into the tumor: a roadmap for T cells. Trends Cancer
2017;3:797-808.
6. Garrido F, Perea F, Bernal M, Sánchez-Palencia A, Aptsiauri N, Ruiz-Cabello F. The escape of cancer from T cell-mediated immune
surveillance: HLA class I loss and tumor tissue architecture. Vaccines 2017;5:7.
7. Carson MJ, Doose JM, Melchior B, Schmid CD, Ploix CC. CNS immune privilege: hiding in plain sight. Immunol Rev 2006;213:48-
65.
8. Rizvi NA, Hellmann MD, Snyder A, Kvistborg P, Makarov V, Havel JJ, Lee W, Yuan J, Wong P, Ho TS, Miller ML, Rekhtman N,
Moreira AL, Ibrahim F, Bruggeman C, Gasmi B, Zappasodi R, Maeda Y, Sander C, Garon EB, Merghoub T, Wolchok JD, Schumacher