Concepts in immuno-oncology: tackling B cell malignancies with CD19-directed bispecific T cell engager therapies.

Abstract

The B cell surface antigen CD19 is a target for treating B cell malignancies, such as B cell precursor acute lymphoblastic leukemia and B cell non-Hodgkin lymphoma. The BiTE® immuno-oncology platform includes blinatumomab, which is approved for relapsed/refractory B cell precursor acute lymphoblastic leukemia and B cell precursor acute lymphoblastic leukemia with minimal residual disease. Blinatumomab is also being evaluated in combination with other agents (tyrosine kinase inhibitors, checkpoint inhibitors, and chemotherapy) in various treatment settings, including frontline protocols. An extended half-life BiTE molecule is also under investigation. Patients receiving blinatumomab may experience cytokine release syndrome and neurotoxicity; however, these events may be less frequent and severe than in patients receiving other CD19-targeted immunotherapies, such as chimeric antigen receptor T cell therapy. We review BiTE technology for treating malignancies that express CD19, analyzing the benefits and limitations of this bispecific T cell engager platform from clinical experience with blinatumomab.

• Authors: Andreas Viardot, Franco Locatelli, Julia Stieglmaier, Faraz Zaman, Elias Jabbour
• Journal: Annals of hematology (Ann Hematol) Vol. 99 Issue 10 Pg. 2215-2229 (Oct 2020) ISSN: 1432-0584 [Electronic] Germany
• PMID: 32856140 (Publication Type: Journal Article, Review)

Chemical References

• Adrenal Cortex Hormones
• Antibodies, Bispecific
• Antigens, CD19
• Antigens, Neoplasm
• Antineoplastic Agents, Immunological
• CD19 molecule, human
• blinatumomab

Topics

• Adolescent
• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Antibodies, Bispecific (administration & dosage, adverse effects, economics, therapeutic use)
• Antigens, CD19 (immunology)
• Antigens, Neoplasm (immunology)
• Antineoplastic Agents, Immunological (administration & dosage, adverse effects, economics, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• B-Lymphocyte Subsets (immunology)
• Child
• Clinical Trials as Topic
• Combined Modality Therapy
• Cost-Benefit Analysis
• Cytokine Release Syndrome (etiology, prevention & control)
• Drug Costs
• Humans
• Immunotherapy, Adoptive (adverse effects, economics)
• Infusions, Intravenous
• Injections, Subcutaneous
• Lymphoma, B-Cell (drug therapy, immunology, therapy)
• Neoplasm, Residual
• Precursor B-Cell Lymphoblastic Leukemia-Lymphoma (drug therapy, immunology, pathology, therapy)
• Premedication
• Quality of Life
• T-Lymphocyte Subsets (immunology)
• Treatment Outcome
• Tumor Burden
• Tumor Escape