Abstract
Immune-based therapeutic strategies have drastically changed the landscape of hematological disorders, as they have introduced the concept of boosting immune responses against tumor cells. Anti-CD20 monoclonal antibodies have been the first form of immunotherapy successfully applied in the treatment of CLL, in the context of chemoimmunotherapy regimens. Since then, several immunotherapeutic approaches have been studied in CLL settings, with the aim of exploiting or eliciting anti-tumor immune responses against leukemia cells. Unfortunately, despite initial promising data, results from pilot clinical studies have not shown optimal results in terms of disease control - especially when immunotherapy was used individually - largely due to CLL-related immune dysfunctions hampering the achievement of effective anti-tumor responses. The growing understanding of the complex interactions between immune cells and the tumor cells has paved the way for the development of new combined approaches that rely on the synergism between novel agents and immunotherapy. In this review, we provide an overview of the most successful and promising immunotherapeutic modalities in CLL, including both antibody-based therapy (i.e. monoclonal antibodies, bispecific antibodies, bi- or tri- specific killer engagers) and adoptive cellular therapy (i.e. CAR T cells and NK cells). We also provide examples of successful new combination strategies and some insights on future perspectives.
Highlights
Chronic Lymphocytic leukemia (CLL) is the most common hematological disorder in the Western world, with an incidence of 4.2/100 000/year that increases to more than 30/100 000/year at an age of >80 years [1]
Over the time several immune-based therapeutic options have been explored in the CLL context, with the ultimate goal of exploiting and/or boosting the patient’s immune system to fight tumor cells
A demonstration of these limitations is provided by the disappointing results obtained with active immunotherapy strategies used individually, which have shown to be ineffective in re-directing against the tumor an immune system that was not competent enough
Summary
Chronic Lymphocytic leukemia (CLL) is the most common hematological disorder in the Western world, with an incidence of 4.2/100 000/year that increases to more than 30/100 000/year at an age of >80 years [1]. Treatment options for CLL patients have enriched and developed over the time, starting from the standard chemotherapy-based approaches containing alkylating agents [2] and purine analogues [3]. Immunotherapy in Chronic Lymphocytic Leukemia in terms of overall response (OR) and OS rates [4], demonstrating for the first time the therapeutic efficacy of strategies exploiting the immune system as a weapon to eliminate tumor cells. We will go through a summary of immune-based approaches explored over the time for the treatment of CLL, discussing the most recent, successful and/or promising advances made in the field of immunotherapy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
