Barts Cancer Institute, Queen Mary University of London, London, U.K.;
Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K.
Anticancer Res. 2021 Mar;41(3):1123-1141. doi: 10.21873/anticanres.14870.
Haematology has been at the vanguard of cancer immunotherapy. Immune checkpoint inhibitors (ICIs), bispecific T-cell engagers (BiTEs), allogeneic haematopoietic stem cell transplantation (allo-HSCT) and donor lymphocyte infusion (DLI), as well as adoptive T-cell therapies outside the setting of allo-HSCT, have been approved for distinct haematologic malignancies producing durable responses in otherwise untreatable patients. Despite recent advances, immunotherapies do not benefit most patients, due to resistance or lack of response, and are only approved in specific settings. Moreover, immunotherapies are expensive and may produce severe immune related adverse reactions. Combination therapy complicates the picture and requires further evaluation. This review considers the current status and future perspectives of ICIs and BiTEs approved for haematological malignancies by analysing their strengths, weaknesses, opportunities and threats (SWOT). The biological rationale for anti-cancer mechanisms, clinical data for specific haematological cancers, efficacy, toxicity, response and resistance profiles, novel strategies to improve these characteristics as well as the potential targets to enhance or expand the application of ICIs and BiTEs are also discussed.
血液学一直处于癌症免疫治疗的前沿。免疫检查点抑制剂（ICIs）、双特异性 T 细胞衔接器（BiTEs）、异基因造血干细胞移植（allo-HSCT）和供者淋巴细胞输注（DLI），以及 allo-HSCT 之外的过继性 T 细胞治疗，已被批准用于多种血液恶性肿瘤，为原本无法治疗的患者带来持久缓解。尽管最近取得了进展，但由于耐药或无反应，免疫疗法并不能使大多数患者受益，并且仅在特定情况下获得批准。此外，免疫疗法昂贵且可能产生严重的免疫相关不良反应。联合治疗使情况变得复杂，需要进一步评估。本综述通过分析血液恶性肿瘤获批的 ICI 和 BiTE 的优势、劣势、机会和威胁（SWOT），考虑了它们的现状和未来前景。还讨论了针对癌症机制的生物学原理、特定血液恶性肿瘤的临床数据、疗效、毒性、反应和耐药谱、改善这些特征的新策略，以及增强或扩大 ICI 和 BiTE 应用的潜在靶点。
