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Who will watch the watchmen: unique challenges of T-cell redirecting therapies in T-cell malignancies
Jessica Elliott1, David Ritchie2, Rachel Koldej1
1ACRF Translational Research Laboratory, Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Clinical Haematology, Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
Abstract:
The development of novel T-cell redirecting immune therapies-including immune checkpoint inhibitors, bispecific antibodies, chimeric antigen receptor T cells, and virus-specific T cells-represents a major advancement in the treatment of haematological malignancies. Although such therapies have strong evidence for efficacy in the treatment of B-cell neoplasms, several unique challenges are encountered when using these therapies for the treatment of T-cell malignancies. In this Review, we discuss the application of T-cell modulating immune therapies in T-cell neoplasms, with a focus on the complicated bidirectional interactions between malignant and bystander T cells in disease pathogenesis, and the resultant challenges affecting the design and deliverability of T-cell modulating therapies in this cohort.
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