Molecularly targeted therapy and immunotherapy in leukemias

The advent of next-generation high-throughput sequencing and precision medicine has allowed the identification of recurrent genetic events of vital interest for leukemic cells and for the management of patients with leukemia, since it has a direct impact on prognosis and therapeutic stratification. The precise cytogenetic characterization of these diseases has rapidly enabled the development of innovative therapeutic strategies to improve outcomes and limit toxicities. New targeted therapies, including small molecule inhibitors, monoclonal antibodies, bispecific T cell engagers, antibody-drug conjugates, recombinant immunotoxins, and chimeric antigen receptor T cells (CAR-T cells) represent a broad therapeutic arsenal now available in everyday practice. The growing number of treatments means that many possibilities of drugs and combinations can be used to offer new lines of therapy in cases of refractory disease or relapse, but also in frontline treatment. This review provides a broad overview of pathogenic mechanisms and therapies (including targeted therapies, immunotherapy and RNA-based therapy) and gathers the main research progress in the field of leukemia.