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@ARTICLE{Fetsch:277752,
author = {V. Fetsch and R. Zeiser$^*$},
title = {{C}himeric antigen receptor {T} cells for acute myeloid
leukemia.},
journal = {European journal of haematology},
volume = {112},
number = {1},
issn = {0902-4441},
address = {Oxford},
publisher = {Wiley-Blackwell},
reportid = {DKFZ-2023-01469},
pages = {28-35},
year = {2024},
note = {2024 Jan;112(1):28-35},
abstract = {The use of T cells expressing chimeric antigen receptors
(CARs) that can target and eliminate cancer cells has
revolutionized the treatment of B-cell malignancies. In
contrast, CAR T cells have not yet become a routine
treatment for myeloid malignancies such as acute myeloid
leukemia (AML) or myeloproliferative neoplasms (MPNs). For
these disease entities, allogeneic hematopoietic cell
transplantation (allo-HCT) relying on polyclonal
allo-reactive T cells is still the major cellular
immunotherapy used in clinical routine. Here, we discuss
major hurdles of CAR T-cell therapy for myeloid malignancies
and novel approaches to enhance their efficacy and reduce
toxicity. Heterogeneity of the malignant myeloid clone, CAR
T-cell induced toxicity against normal hematopoietic cells,
lack of long-term CAR T-cell persistence, and loss or
downregulation of targetable antigens on myeloid cells are
obstacles for successful CAR T cells therapy against AML and
MPNs. Strategies to overcome these hurdles include
pharmacological interventions, for example, demethylating
therapy to increase target antigen expression,
multi-targeted CAR T cells, and gene-therapy based
approaches that delete the CAR target antigen in the
hematopoietic cells of the recipient to protect them from
CAR-induced myelotoxicity. Most of these approaches are
still in preclinical testing but may reach the clinic in the
coming years. In summary, we report on barriers to CAR
T-cell use against AML and novel therapeutic strategies to
overcome these challenges, with the goal of clinical
treatment of myeloid malignancies with CAR T cells.},
subtyp = {Review Article},
keywords = {CAR T cells (Other) / acute myeloid leukemia (Other) /
immune escape (Other) / multitargeted CAR T cells (Other) /
myelotoxicity (Other)},
cin = {FR01},
ddc = {610},
cid = {I:(DE-He78)FR01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37455578},
doi = {10.1111/ejh.14047},
url = {https://inrepo02.dkfz.de/record/277752},
}