Next-generation leukemia immunotherapy
Cet article passe en revue les perspectives offertes par de nouvelles stratégies d'immunothérapie pour le traitement des leucémies
Allogeneic hematopoietic cell transplantation (AHCT) led to the discovery of the allogeneic graft-versus-leukemia (GVL) effect, which remains the most convincing evidence that immune cells can cure cancer in humans. However, despite its great paradigmatic and clinical relevance, induction of GVL by conventional AHCT remains a quite rudimentary form of leukemia immunotherapy. It is toxic and its efficacy is far from optimal. It is therefore sobering that since the discovery of the GVL effect three decades ago, the way GVL is induced and manipulated has practically not changed. Pre-clinical and clinical studies suggest that injection of T cells primed against a single antigen (Ag) present on neoplastic cells could enhance the GVL effect without causing any GVHD. We therefore contend that Ag-targeted adoptive T-cell immunotherapy (ATCI) represents the future of leukemia immunotherapy and we discuss the specific strategies that ought to be evaluated to reach this goal. Differences between these strategies hinge on two key elements: the nature of the target Ag and the type of Ag receptor expressed on T cells.
Blood 2011