Targeted antibody therapy as a treatment strategy for aggressive adult T-cell leukemia/lymphoma.

The standard treatment for aggressive adult T-cell leukemia/lymphoma (ATL) is multi-agent chemotherapy, but the use of more intense cytotoxic anticancer agents is becoming more difficult with the aging of patients at the time of diagnosis. As a means of overcoming this hurdle, antibody drugs, which are supposed to be less toxic, have been developed for ATL. The advent of the anti-CC chemokine receptor 4 (CCR4) antibody mogamulizumab has significantly advanced ATL treatment. Real-world data and a phase 2 clinical trial suggest the efficacy and manageable safety profile of mogamulizumab with combination chemotherapy in elderly patients. Interestingly, mogamulizumab has performed well in cases with CCR4 mutations and cutaneous adverse events. In addition, emerging immunotherapies, including Tax peptide dendritic cell vaccines, immune checkpoint inhibitors, and Chimeric Antigen Receptor-T cell therapy, are under investigation. These innovative approaches aim to enhance immunogenic responses and offer hope for better outcomes in this challenging malignancy.