Who will watch the watchmen: unique challenges of T-cell redirecting therapies in T-cell malignancies.

Abstract

The development of novel T-cell redirecting immune therapies-including immune checkpoint inhibitors, bispecific antibodies, chimeric antigen receptor T cells, and virus-specific T cells-represents a major advancement in the treatment of haematological malignancies. Although such therapies have strong evidence for efficacy in the treatment of B-cell neoplasms, several unique challenges are encountered when using these therapies for the treatment of T-cell malignancies. In this Review, we discuss the application of T-cell modulating immune therapies in T-cell neoplasms, with a focus on the complicated bidirectional interactions between malignant and bystander T cells in disease pathogenesis, and the resultant challenges affecting the design and deliverability of T-cell modulating therapies in this cohort.