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Immunotherapy for Acute Lymphoblastic Leukemia: An Embarrassment of Riches

The long sought dream of activating the immune system to eradicate cancer is being realized for patients with acute lymphoblastic leukemia (ALL). A number of creative strategies are being employed to harness the cytotoxic potential of the T-cell with impressive results, even in patients with advanced disease. For patients with B-cell ALL, both genetically engineered chimeric antigen receptor T-cells (CAR-Ts) targeting CD19 and the CD3-CD19 bispecific T-cell engaging antibody (BiTE) have potent anti-leukemia activity and result in high remission rates. Other immunotherapeutic targets, including CD22, are also generating great therapeutic interest.

Given this recent explosion of highly active immunotherapeutic approaches for our patients with ALL, we are now on the verge of facing a new challenge:  how to choose the best approach?  In this timely point—counterpoint discussion, Drs. Davis and Mackall from Stanford University provide both the exciting evidence for the use of CAR-Ts and the challenges facing us as we begin to more widely deploy these genetically engineered T-cells for treatment of ALL while Drs. Jabbour and Kantarjian of the MD Anderson Cancer Center review the merits and weaknesses of the CD-19 BiTE and other new antibody conjugates and address the challenge of moving these treatments to the frontline setting.  It is, indeed, a time of tremendous optimism in our field, and the point-counterpoint commentary from our experts serves as nice therapeutic blueprint as we move forward!

Copyright © 2016 American Society for Hematology

Creative strategies activating the immune system to eradicate cancer is being realized for patients with acute lymphoblastic leukemia (ALL)