Abstract
Haematological malignancies are a heterogenous group of diseases mostly of immunological origin. Immunotherapies such as allogeneic stem cell transplantation and monoclonal antibodies have been an essential part of managing haematological malignancies for decades, though recent understanding of tumour and microenvironment biology has led to the development of highly effective targeted therapies. Inhibiting immune checkpoints such as programmed death-1 (PD-1) and its ligand (PD-L1) have yielded remarkable results in some highly refractory lymphoma subtypes such as relapsed classical Hodgkin Lymphoma. Autologous T-cells with chimeric antigen receptors (CARs) are highly effective in B-lineage acute lymphoblastic leukaemia (B-ALL) and appear promising in diffuse large B cell lymphoma (DLBCL) and myeloma. Bispecific antibodies such as blinatumomab are superior to salvage chemotherapy for relapsed/refractory B-ALL and have become standard of care. However, significant challenges remain in cost, deliverability and manufacture of some of these products. Certain haematological malignancies such as myelodysplastic syndrome and acute myeloid leukaemia remain poorly responsive to current immunotherapy, though new agents show promising pre-clinical data. Immunotherapy is a pillar of management for haematological malignancies and are likely curing a subset of patients previously considered incurable; the clinical challenge is determining how to employ these therapies for maximal benefit and minimal toxicity.
Original language | English |
---|---|
Pages (from-to) | 40-58 |
Number of pages | 19 |
Journal | Cancer Forum |
Volume | 42 |
Issue number | 1 |
Publication status | Published - Apr 2018 |