Overcoming the challenges associated with CD3+ T-cell redirection in cancer

Br J Cancer. 2021 Mar;124(6):1037-1048. doi: 10.1038/s41416-020-01225-5. Epub 2021 Jan 19.

Abstract

The development of bispecific antibodies that redirect the cytotoxic activity of CD3+ T cells to tumours is a promising immunotherapeutic strategy for the treatment of haematological malignancies and solid cancers. Since the landmark FDA approval at the end of 2014 of the anti-CD3 × anti-CD19 bispecific antibody blinatumomab (Blincyto®) for the treatment of relapsed/refractory B-cell acute lymphoblastic leukaemia, ~100 clinical trials investigating the safety and efficacy of CD3+ bispecific T-cell redirectors for cancer have been initiated. However, despite early success, numerous challenges pertaining to CD3+ T-cell redirection in the context of cancer exist, including the recruitment of counterproductive CD3+ T-cell subsets, the release of systemic cytokines, the expansion of immune checkpoint molecules, the presence of an immunosuppressive tumour microenvironment, tumour antigen loss/escape, on-target off-tumour toxicity and suboptimal potency. The aim of the present review is to discuss novel approaches to overcome the key challenges associated with CD3+ bispecific T-cell redirection in order to achieve an optimal balance of anti-tumour activity and safety.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antibodies, Bispecific / therapeutic use*
  • Antigens, CD19 / immunology*
  • Antineoplastic Agents / therapeutic use*
  • CD3 Complex / immunology*
  • Humans
  • Neoplasms / drug therapy*
  • Neoplasms / immunology
  • Neoplasms / pathology
  • Tumor Microenvironment / immunology*

Substances

  • Antibodies, Bispecific
  • Antigens, CD19
  • Antineoplastic Agents
  • CD3 Complex
  • blinatumomab