Abstract

Simple SummaryChildren with high-risk neuroblastoma have limited therapeutic options poor survival rates. The neuroblastoma tumor microenvironment contributes the lack of response to many interventions so innovative methods are needed to study the effects of the tumor microenvironment on new therapies. In this manuscript, we review the current literature related to the components of the tumor microenvironment and to the use of three-dimensional printing as modality to study cancer. This review highlights the potential for using three-dimensional printing to create an artificial tumor microenvironment in the presence of neuroblastoma to provide improved preclinical testing of novel therapies.In the quest to advance neuroblastoma therapeutics, there is a need to have a deeper understanding of the tumor microenvironment (TME). From extracellular matrix proteins to tumor associated macrophages, the TME is a robust and diverse network functioning in symbiosis with the solid tumor. Herein, we review the major components of the TME including the extracellular matrix, cytokines, immune cells, and vasculature that support a more aggressive neuroblastoma phenotype and encumber current therapeutic interventions. Contemporary treatments for neuroblastoma are the result of traditional two-dimensional culture studies and in vivo models that have been translated to clinical trials. These pre-clinical studies are costly, time consuming, and neglect the study of cofounding factors such as the contributions of the TME. Three-dimensional (3D) bioprinting has become a novel approach to studying adult cancers and is just now incorporating portions of the TME and advancing to study pediatric solid. We review the methods of 3D bioprinting, how researchers have included TME pieces into the prints, and highlight present studies using neuroblastoma. Ultimately, incorporating the elements of the TME that affect neuroblastoma responses to therapy will improve the development of innovative and novel treatments. The use of 3D bioprinting to achieve this aim will prove useful in developing optimal therapies for children with neuroblastoma.

Highlights

  • Neuroblastoma, a tumor of neural crest cells, is the most common extracranial solid tumor in children and accounts for 15% of pediatric cancer related deaths [1]

  • When neuroblastoma cells were co-cultured with mesenchymal stromal cells, there was an increase in IL-6 levels [23] and subsequent increased activity of STAT signaling that resulted in resistance of the neuroblastoma cells to etoposide [41]

  • Another mechanism found in neuroblastoma is a lack of monocyte chemoattractant protein-1 (MCP-1) production compared to tumors like medulloblastoma, that have a higher percentage of infiltrating T cells and more MCP-1 [75]

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Summary

Introduction

Neuroblastoma, a tumor of neural crest cells, is the most common extracranial solid tumor in children and accounts for 15% of pediatric cancer related deaths [1]. Unlike pediatric hematologic malignancies that have seen remarkable increases in survival and treatment advancements in recent decades, the prognosis for neuroblastoma has not improved dramatically. Mesenchymal cells, stromal cells, and a dense extracellular matrix (ECM), the TME of neuroblastoma creates an unfavorable environment for a variety of therapeutics. Cancers 2021, 13, x Cancers 2021, 13, 1629 an unfavorable environment for a variety of therapeutics. Recent studies on the TME have rreevveeaalleedd iimmppoorrttaanntt ddiissccoovveerriieess,, ssuucchh aass MMYYCCNN bbeeiinngg aa ddrriivveerr ffoorr tthhee iimmmmuunnoossuupppprreessssiivvee nnaattuurree ooff tthhee TTMMEE,, aanndd ffuurrtthheerr rreesseeaarrcchh ccoouulldd pprroovvee bbeenneeffiicciiaall ttoo mmaakkiinngg mmoorree eefffificcaacciioouuss nneeuurroobbllaassttoommaatthheerraappiieess..HHeerree,,wweeininitiitaialllylychcharaarcatcetreirziezethtehecocmompopnoennetnstosfothf ethTeMTEMhEohstoilsettiolectuorrceunrrtetnhtetrhaepreaupteicustifcosrfonrenueroubrolabsltaosmtoam, aid, iednetniftyifythtehemmododalailtiiteisesuuseseddtotoggaatthheerr tthheessee ffiinnddiinnggss,, aanndd pprrooppoossee tthhee nnoovveellttyy ooff tthhrreeee--ddiimmeennssiioonnaall pprriinnttiinngg ttoo ffuurrtthheerr aaddvvaannccee oouurr uunnddeerrssttaannddiinngg ooff tthhee TTMMEE iinn nneeuurroobbllaassttoommaa

The Therapeutic Barriers of the Neuroblastoma Tuummoorr
Cancer Associated Fibroblasts
Mesenchymal Stromal Cells
Schwann Cells
Myeloid Derived Suppressor Cells
T Lymphocytes
Natural Killer Cells
Vasculature
Three-Dimensional Bioprinting
Three-Dimensional Bioprinting in Neuroblastoma
Findings
Conclusions
Full Text
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