{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T06:43:14Z","timestamp":1776062594169,"version":"3.50.1"},"reference-count":133,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Medulloblastoma is a severe pediatric brain tumor with distinct molecular subtypes\u2014WNT, SHH, Group 3, and Group 4-each having unique genetic drivers and immune microenvironments. This review highlights the immune characteristics of each subtype: SHH is rich in tumor-associated macrophages (TAMs), whose role in tumorigenesis is debated; Group 3 features cytotoxic T cells often neutralized by immune checkpoints like PD-L1, causing T cell exhaustion; and Group 4 is marked by natural killer (NK) cells and B cells. These immune landscapes, including tumor-associated astrocytes (TAAs) and abnormal vascular networks, influence tumor growth, spread, and treatment response. Precision immunotherapy must be tailored to specific subtypes. This article discusses CAR T-cell therapy targeting antigens like B7-H3 and GD2, prevalent in SHH subtypes, and examines immune checkpoint blockades targeting PD-1\/PD-L1 and CD47\u2013SIRP\u03b1. It also highlights innovative methods like oncolytic viruses to transform \u201ccold\u201d tumor microenvironments and combination therapies using CSF1R inhibitors and tumor-associated antigens to boost anti-tumor responses. Understanding the immune microenvironment\u2019s subtype-specific heterogeneity in medulloblastoma is crucial for advancing precision immunotherapy and improving patient outcomes.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1714134","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T05:44:42Z","timestamp":1776059082000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Decoding the immune microenvironment: precision immunotherapy for medulloblastoma subtypes"],"prefix":"10.3389","volume":"17","author":[{"given":"Mengyuan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, The First College of Clinical Medical Science, Three Gorges University and Yichang Central People\u2019s Hospital","place":["Yichang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jihong","family":"Peng","sequence":"additional","affiliation":[{"name":"Center for Medical Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First College of Clinical Medical Science, Three Gorges University and Yichang Central People\u2019s Hospital","place":["Yichang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinyang","family":"Hu","sequence":"additional","affiliation":[{"name":"Wenzhou Medical University","place":["Wenzhou, China"]},{"name":"Department of Neurosurgery, The Second Affiliated Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2116344","article-title":"Brain tumors in 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