Redirecting T cells to hematological malignancies with bispecific antibodies.
Mireya Paulina VelasquezChallice L BonifantStephen GottschalkPublished in: Blood (2017)
There is a need to improve outcomes for patients with recurrent and/or refractory hematological malignancies. Immunotherapy holds the promise to meet this need, because it does not rely on the cytotoxic mechanism of conventional therapies. Among different forms of immunotherapy, redirecting T cells to hematological malignancies with bispecific antibodies (BsAbs) is an attractive strategy. BsAbs are an "off-the-shelf" product that is easily scalable in contrast to adoptive T-cell therapies. Among these, the bispecific T-cell engager blinatumomab has emerged as the most successful BsAb to date. It consists of 2 single-chain variable fragments specific for CD19 present on B-cell malignancies and CD3 expressed on almost all T cells. Blinatumomab has shown potent antitumor activity as a single agent, particularly for acute lymphoblastic leukemia, resulting in its US Food and Drug Administration approval. However, although successful in inducing remissions, these are normally short-lived, with median response durations of <1 year. Nevertheless, the success of blinatumomab has reinvigorated the BsAb field, which is bustling with preclinical and clinical studies for not only B-cell-derived lymphoblastic leukemia and lymphoma but also acute myeloid leukemia and multiple myeloma. Here, we will review the successes and challenges of T-cell-targeted BsAbs for the immunotherapy of hematological malignancies with special focus on conducted clinical studies and strategies to improve their efficacy.
Keyphrases
- acute lymphoblastic leukemia
- acute myeloid leukemia
- allogeneic hematopoietic stem cell transplantation
- drug administration
- multiple myeloma
- cell therapy
- type diabetes
- stem cells
- cancer therapy
- diffuse large b cell lymphoma
- machine learning
- mesenchymal stem cells
- adipose tissue
- drug delivery
- skeletal muscle
- metabolic syndrome
- anti inflammatory
- weight loss