Immune-Based Approaches in AML

Abstract

Immunotherapy has revolutionized cancer therapy. Several immunotherapeutic approaches to harness the immune system and reinstate immunosurveillance have been established, including naked and conjugated monoclonal antibodies, immune checkpoint inhibitors, bispecific T-cell engager antibodies, and adoptive cellular therapy with chimeric antigen receptor (CAR) T and NK cells. A number of these approaches have been successfully used in clinical practice for several solid and hematological malignancies. In AML, a number of these immunotherapeutic approaches are currently in different stages of preclinical and clinical development. In this chapter, we discuss the preclinical rationale, current clinical development status, emerging efficacy and safety signals, and future directions including combinatorial approaches and optimal settings for the application of such immunotherapies in the treatment landscape of AML. We focus on immune checkpoint inhibitors, bispecific T-cell engager antibodies, and adoptive cellular therapy with CAR T-cells for patients with AML. The ongoing preclinical and clinical trials with in-depth analysis of biomarkers should improve our understanding of the immunobiology of AML.