4.5 Review

Targeted therapy and immunotherapy for T cell acute lymphoblastic leukemia/lymphoma

Related references

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Article Cell Biology

PD-1 signalling defines and protects leukaemic stem cells from T cell receptor-induced cell death in T cell acute lymphoblastic leukaemia

Xi Xu et al.

Summary: “T cell acute lymphoblastic leukemia (T-ALL) is an aggressive malignancy. In this study, a rare inhibitory receptor called programmed cell death 1 (PD-1) was identified as a marker for leukemia stem cells (LSCs) in T-ALL. Blocking PD-1 significantly eradicated LSCs and suppressed disease progression, and combination therapy with PD-1 blockade and chemotherapy extended survival. Mechanistically, PD-1+ LSCs had high NOTCH1-MYC activity and were protected against apoptosis. These findings provide a therapeutic approach for eliminating LSCs in T-ALL.”

NATURE CELL BIOLOGY (2023)

Article Oncology

Long-term follow-up of donor-derived CD7 CAR T-cell therapy in patients with T-cell acute lymphoblastic leukemia

Yue Tan et al.

Summary: In this long-term follow-up study, donor-derived CD7 CAR T-cell treatment showed durable efficacy in a subset of patients with r/r T-ALL. However, disease relapse and severe infection were major causes of treatment failure.

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Article Oncology

Targeting the NOTCH1-MYC-CD44 axis in leukemia-initiating cells in T-ALL

Sujan Piya et al.

Summary: This study investigates the role of BRD4 in T-cell acute lymphoblastic leukemia (T-ALL) and demonstrates that targeting BRD4 can disrupt the NOTCH1-MYC-CD44 axis, leading to extended survival in mouse models. The study provides evidence for BRD4 degradation as a promising therapy for targeting leukemia-initiating cells (LICs) in T-ALL.

LEUKEMIA (2022)

Article Oncology

Isatuximab monotherapy in patients with refractory T-acute lymphoblastic leukemia or T-lymphoblastic lymphoma: Phase 2 study

Nicolas Boissel et al.

Summary: This study aimed to evaluate the efficacy and safety of Isatuximab monotherapy in patients with relapsed or refractory T-ALL or T-LBL. However, the results showed low efficacy of Isatuximab, with most patients experiencing disease progression and treatment-related adverse events.

CANCER MEDICINE (2022)

Article Oncology

Chidamide inhibits the NOTCH1-MYC signaling axis in T-cell acute lymphoblastic leukemia

Mengping Xi et al.

Summary: This study found that the HDAC inhibitor chidamide has an anti-tumor effect on T-ALL cells, particularly by inhibiting the NOTCH1-MYC signaling axis. Clinical trial results support that chidamide treatment reduces minimal residual disease in patients and is well tolerated.

FRONTIERS OF MEDICINE (2022)

Article Oncology

Feasibility study of a novel preparation strategy for anti-CD7 CAR-T cells with a recombinant anti-CD7 blocking antibody

Jing Ye et al.

Summary: This article reports a new strategy of blocking the CD7 antigen on T cells using a recombinant anti-CD7 antibody to obtain sufficient CD7-targeting CAR-T cells for the treatment of T cell acute lymphoblastic leukemia (T-ALL). The feasibility of this approach was systematically evaluated, showing that blocking the CD7 antigen effectively prevented fratricide, increased expansion rate, reduced the proportion of regulatory T cells, maintained the stem cell-like characteristics of T cells, and restored the proportion of CD8(+) T cells.

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Article Oncology

Venetoclax for Children and Adolescents with Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma

Amber Gibson et al.

Summary: This study retrospectively reviewed the safety and efficacy of Venetoclax in pediatric and young adult patients with relapsed or refractory acute lymphoblastic leukemia (ALL) or lymphoma (LBL). The results showed that Venetoclax is safe and effective to use in pediatric patients with ALL/LBL and should be considered in both the relapsed and upfront settings.

CANCERS (2022)

Article Hematology

Naturally selected CD7 CAR-T therapy without genetic manipulations for T-ALL/LBL: first-in-human phase 1 clinical trial

Peihua Lu et al.

Summary: NS7CAR-T therapy is a safe and highly effective treatment for T-ALL/LBL, leading to minimal residual disease negative complete remission in patients. In clinical trials, no relapses were observed in 14 patients, highlighting the potential of this treatment.

BLOOD (2022)

Article Hematology

Anti-CCR9 chimeric antigen receptor T cells for T-cell acute lymphoblastic leukemia

Paul M. Maciocia et al.

Summary: CCR9 expression is found in the majority of T-ALL cases, making it a potential target for CAR-T cell therapy. CAR-T cells targeting CCR9 can effectively inhibit leukemia cell proliferation without harming healthy T cells, providing a promising treatment strategy for T-ALL.

BLOOD (2022)

Article Oncology

CRLF2 overexpression defines an immature-like subgroup which is rescued through restoration of the PRC2 function in T-cell precursor acute lymphoblastic leukemia

Ana L. T. Maciel et al.

Summary: This study utilized RNA-seq, WES, and SNP-array data to uncover the genomic profile of CRLF2-high in T-ALL, revealing mutations in PTEN, JAK3, PHF6, EZH2, and RUNX1. The study also found an enrichment of CRLF2-high in ETP-ALL and a similar gene upregulation pattern between the two entities. Furthermore, the study highlighted the crucial role of PRC2 in CRLF2 regulation in ETP-ALL.

GENES CHROMOSOMES & CANCER (2022)

Article Oncology

JAK3 mutations and mitochondrial apoptosis resistance in T-cell acute lymphoblastic leukemia

Kimberly Bodaar et al.

Summary: Resistance to mitochondrial apoptosis is associated with activating mutations of JAK3 in patients with diverse tumor types, including T-ALL. Inhibition of JAK3 reverses the apoptotic blockade and shows synergy with glucocorticoids in JAK3-mutant T-ALL.

LEUKEMIA (2022)

Article Oncology

CD38: A target in relapsed/refractory acute lymphoblastic leukemia-Limitations in treatment and diagnostics

Vakrmanova Barbora et al.

Summary: Daratumumab, an experimental drug for relapsed acute lymphoblastic leukemia, showed varying efficacy in our study. It demonstrated good response in some T-ALL patients, but also resulted in treatment failure and patient deaths. Additionally, we highlighted the importance of monitoring leukemia burden and avoiding misinterpretation of CD38 expression in leukemic cells after daratumumab treatment.

PEDIATRIC BLOOD & CANCER (2022)

Letter Oncology

NUP214-ABL1 fusion in childhood T-ALL

Giulia Veltri et al.

PEDIATRIC BLOOD & CANCER (2022)

Article Oncology

Prognostic Significance of Comprehensive Gene Mutations and Clinical Characteristics in Adult T-Cell Acute Lymphoblastic Leukemia Based on Next-Generation Sequencing

Hua Yin et al.

Summary: By analyzing gene mutations and clinical characteristics of adult T-cell acute lymphoblastic leukemia/lymphoma patients, three new risk stratification models were established. These models have a good prognostic role in guiding personalized treatment and improving patient outcomes.

FRONTIERS IN ONCOLOGY (2022)

Article Pediatrics

CD7 CAR T bridging to allo-HSCT in R/R T-ALL: A case report

Meng Fanqiao et al.

Summary: CD7 CAR T-cells bridging to allo-HSCT is a safe and effective approach for refractory/relapsed T-cell acute lymphoblastic leukemia (R/R T-ALL), resulting in durable complete remission and longer survival.

PEDIATRIC TRANSPLANTATION (2022)

Article Oncology

A Novel Bispecific T-Cell Engager (CD1a x CD3ε) BTCE Is Effective against Cortical-Derived T Cell Acute Lymphoblastic Leukemia (T-ALL) Cells

Caterina Riillo et al.

Summary: This study developed a novel bispecific T-cell engager (BTCE) that targets CD1a and CD3ε and recruits T cells to fight against T-ALL cells. The BTCE demonstrated effective killing of T-ALL cells both in vitro and in vivo, suggesting its potential as a therapeutic option for CD1a-expressing T-ALL patients.

CANCERS (2022)

Review Immunology

CAR NK cell therapy in hematologic malignancies and solid tumors; obstacles and strategies to overcome the challenges

Ayda Baghery Saghchy Khorasani et al.

Summary: CAR NK cells have attracted attention as a viable alternative to CAR T cells due to their MHC-independency, shorter life expectancy, potential for off-the-shelf immune product creation, and potent antitumor properties. This article provides an updated review of the differences between CAR T and CAR NK cells, current enhancements in CAR NK design, sources for collecting NK cells, and strategies for transducing CARs to NK cells.

INTERNATIONAL IMMUNOPHARMACOLOGY (2022)

Article Oncology

JAK/BCL2 inhibition acts synergistically with LSD1 inhibitors to selectively target ETP-ALL

Aissa Benyoucef et al.

Summary: ETP-ALL is a high-risk subtype of T cell acute lymphoblastic leukemia that often relapses after conventional chemotherapy. In this study, the authors discovered the novel involvement of ZEB2/LSD1 complexes in repressing the intrinsic apoptosis pathway and identified BIM as a major driver for ETP-ALL survival. Treatment with LSD1 inhibitors restored the expression of BIM and, when combined with other inhibitors, reversed the resistance of ETP-ALL to LSD1 inhibitors, leading to inhibited growth and enhanced differentiation of ETP-ALL cells.

LEUKEMIA (2022)

Article Biochemistry & Molecular Biology

T cells expressing CD5/CD7 bispecific chimeric antigen receptors with fully human heavy-chain-only domains mitigate tumor antigen escape

Zhenyu Dai et al.

Summary: Bispecific chimeric antigen receptor T-cell (CAR-T) therapies have shown promising results in clinical trials for advanced B-cell malignancies. However, targeting multiple T-cell-expressing antigens can lead to CAR-T cell fratricide and safety concerns. This study developed fully human heavy chain variable (FHVH) antibodies that specifically target CD5 or CD7 and constructed CD5/CD7 bispecific CARs. The addition of a truncated Epidermal growth factor receptor was integrated into CAR constructs to address safety concerns. CRISPR/Cas9-based knockout of CD5 and CD7 genes was performed to prevent fratricide. Functional comparison showed that FHVH-derived CD5/CD7 bispecific CAR-T cells demonstrated potent antitumor activity, and the use of tandem CARs was more effective in preventing tumor escape. The clinical efficacy and safety of tandem CD5/CD7 CAR-T cells should be urgently explored.

SIGNAL TRANSDUCTION AND TARGETED THERAPY (2022)

Review Medicine, Research & Experimental

Progress in research on childhood T-cell acute lymphocytic leukemia, Notch1 signaling pathway, and its inhibitors: A review

Zhong Fang-Fang et al.

Summary: Childhood leukemia poses a serious threat to children's lives in China, with poor chemotherapy sensitivity and susceptibility to drug resistance in T-cell acute lymphocytic leukemia (T-ALL). Notch1 gene mutations are common in human T-ALLs, with the Notch signaling pathway playing a role in the disease pathogenesis. Developing targeted drugs and individualized treatment is crucial for improving the clinical management of T-ALL.

BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES (2021)

Article Hematology

Single-cell RNA-seq reveals developmental plasticity with coexisting oncogenic states and immune evasion programs in ETP-ALL

Praveen Anand et al.

Summary: By conducting full-length single-cell RNA sequencing, we identified two highly distinct stem-like states in early T-cell progenitor acute lymphoblastic leukemia (ETP-ALL), which differed significantly in terms of cell cycle and oncogenic signaling, as well as dependence on Notch activation and PI3K signaling. Our study revealed complex interactions between signaling programs, cellular plasticity, and immune programs in ETP-ALL, highlighting the multidimensionality of tumor heterogeneity.

BLOOD (2021)

Letter Oncology

CAR T cells targeting CD99 as an approach to eradicate T-cell acute lymphoblastic leukemia without normal blood cells toxicity

Jiangzhou Shi et al.

Summary: The study demonstrates that anti-CD99 CAR T cells can specifically recognize and efficiently eliminate CD99+ leukemia cells.

JOURNAL OF HEMATOLOGY & ONCOLOGY (2021)

Article Oncology

Combination therapy with miR-34a and doxorubicin synergistically induced apoptosis in T-cell acute lymphoblastic leukemia cell line

Shiva Najjary et al.

Summary: MicroRNAs play an active role in cancer development, and restoring the expression of tumor suppressor miRNAs can be a viable treatment option. Combining chemotherapy with miRNAs can help overcome drug resistance and improve the efficacy of cancer treatment.

MEDICAL ONCOLOGY (2021)

Article Oncology

Therapeutic afucosylated monoclonal antibody and bispecific T-cell engagers for T-cell acute lymphoblastic leukemia

Daniele Caracciolo et al.

Summary: T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive disease with a poor cure rate, lacking effective immune-therapeutics. In this study, an afucosylated monoclonal antibody and two bispecific T-cell engagers targeting UMG1 on T-ALL cells were developed and shown to have high killing activity. These findings provide a potential clinical development for innovative immune-therapeutics for T-ALL.

JOURNAL FOR IMMUNOTHERAPY OF CANCER (2021)

Article Oncology

BRD4 PROTAC degrader ARV-825 inhibits T-cell acute lymphoblastic leukemia by targeting 'Undruggable' Myc-pathway genes

Shuiyan Wu et al.

Summary: BRD4 expression is elevated in pediatric T-ALL samples, indicating a poor prognosis. ARV-825 effectively suppresses T-ALL cell proliferation by arresting the cell cycle and inducing apoptosis, reducing BRD4, BRD3, and BRD2 proteins, and perturbing the H3K27Ac-Myc pathway. In addition, ARV-825 inhibits tumor growth in a T-ALL xenograft model by depleting BET and c-Myc proteins.

CANCER CELL INTERNATIONAL (2021)

Article Hematology

PRC2 loss of function confers a targetable vulnerability to BET proteins in T-ALL

Guillaume P. Andrieu et al.

Summary: PRC2 alterations are common in T-ALL and are associated with activating mutations of the IL7R/JAK/STAT pathway. Loss of PRC2 function reshapes the genetic and epigenetic landscapes, leading to reactivation of stem cell programs that cooperate with BET proteins to sustain T-ALL. There is a targetable vulnerability to BET inhibition in PRC2-altered T-ALL patients.

BLOOD (2021)

Article Oncology

Donor-Derived CD7 Chimeric Antigen Receptor T Cells for T-Cell Acute Lymphoblastic Leukemia: First-in-Human, Phase I Trial

Jing Pan et al.

Summary: Donor-derived anti-CD7 CAR T cells showed efficient expansion and high complete remission rate in patients with r/r T-ALL, with manageable adverse events.

JOURNAL OF CLINICAL ONCOLOGY (2021)

Article Oncology

PSEN1-selective gamma-secretase inhibition in combination with kinase or XPO-1 inhibitors effectively targets T cell acute lymphoblastic leukemia

Inge Govaerts et al.

Summary: In the treatment of T-ALL, combination treatment strategies using PSEN1-selective gamma-secretase inhibitor MRK-560 with other targeted agents show synergistic effects, reducing leukemia infiltration and providing survival benefits.

JOURNAL OF HEMATOLOGY & ONCOLOGY (2021)

Article Oncology

Acute Lymphoblastic Leukemia, Version 2.2021

Patrick A. Brown et al.

Summary: The NCCN Guidelines for Acute Lymphoblastic Leukemia (ALL) focus on classification, risk assessment, treatment strategies, and supportive care for ALL patients. Treatment at a specialized cancer center with expertise in ALL management is recommended. The guidelines specifically address the management of Ph-positive and Ph-negative ALL in adolescents and young adults, as well as in relapsed settings.

JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK (2021)

Article Oncology

Base-edited CAR T cells for combinational therapy against T cell malignancies

Christos Georgiadis et al.

Summary: The use of base editing technology allows for the generation of CAR T cells with resistance to T cell fratricide, enabling enhanced cytotoxic effects against specific targets. Co-cultured 3CAR and 7CAR cells exhibit high cytotoxicity, particularly effective against CD3 + CD7 + T-ALL targets.

LEUKEMIA (2021)

Article Biotechnology & Applied Microbiology

The rational development of CD5-targeting biepitopic CARs with fully human heavy-chain-only antigen recognition domains

Zhenyu Dai et al.

Summary: A novel CD5-targeting biepitopic CAR was developed with optimized manufacturing procedures to prevent fratricide, resulting in enhanced and longer lasting efficacy in vitro and in vivo. The biepitopic CD5KO FHV(H)3/V(H)1 CAR-T cells exhibited moderate levels of cytokine secretion and similar specificity profiles as other tested structures, showing potential for further development.

MOLECULAR THERAPY (2021)

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Network-based systems pharmacology reveals heterogeneity in LCK and BCL2 signaling and therapeutic sensitivity of T-cell acute lymphoblastic leukemia

Yoshihiro Gocho et al.

Summary: The study identified LCK and BCL2 signaling as molecular determinants of dasatinib response in T-ALL patients and provided unique opportunities for targeted therapy. High BCL-XL activity, low BCL2 activity and venetoclax resistance were associated with dasatinib-sensitive T-ALL. Discordant sensitivity to dasatinib and venetoclax in T-ALL was correlated with T-cell differentiation and dynamic shift in LCK versus BCL2 activation.

NATURE CANCER (2021)

Article Cell & Tissue Engineering

Treatment of Aggressive T Cell Lymphoblastic Lymphoma/leukemia Using Anti-CD5 CAR T Cells

Jia Feng et al.

Summary: In this study, the modification of CD5 CAR to secrete an IL-15/IL-15sushi complex successfully targeted CNS-invading T-LBL, leading to the rapid ablation of lymphoblasts and remission of lymphoma in the patient. Despite the presence of CD5 on normal T cells, the treatment only caused brief, transient T-cell aplasia. These results suggest that CD5-IL15/IL15sushi CAR T cells may offer a safe and effective treatment option for T-cell malignancies, particularly for those with CNS involvement.

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Phase 1 study to evaluate Crenigacestat (LY3039478) in combination with dexamethasone in patients with T-cell acute lymphoblastic leukemia and lymphoma

Gautam Borthakur et al.

Summary: The study included 36 patients with T-ALL (n = 31, 86.1%) or T-LBL (n = 5, 13.9%) who received treatment with Crenigacestat and dexamethasone, with the maximum tolerated dose being 75 mg of Crenigacestat plus 24 mg of dexamethasone daily. Overall, Crenigacestat demonstrated limited clinical activity in adult patients with relapsed/refractory T-ALL/T-LBL.

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Characterization of an Anti-CD5 Directed CAR T-Cell against T-Cell Malignancies

Masayuki Wada et al.

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How I treat T-cell acute lymphoblastic leukemia in adults

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