{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:42:02Z","timestamp":1792201322451,"version":"4.4.0"},"reference-count":52,"publisher":"American Society of Hematology","issue":"10","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/legalcode"}],"content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>T-cell\u2013recruiting bispecific molecule therapy has yielded promising results in patients with hematologic malignancies; however, resistance and subsequent relapse remains a major challenge. T-cell exhaustion induced by persistent antigen stimulation or tonic receptor signaling has been reported to compromise outcomes of T-cell\u2013based immunotherapies. The impact of continuous exposure to bispecifics on T-cell function, however, remains poorly understood. In relapsed\/refractory B-cell precursor acute lymphoblastic leukemia patients, 28-day continuous infusion with the CD19xCD3 bispecific molecule blinatumomab led to declining T-cell function. In an in\u00a0vitro model system, mimicking 28-day continuous infusion with the half-life\u2013extended CD19xCD3 bispecific AMG 562, we identified hallmark features of exhaustion arising over time. Continuous AMG 562 exposure induced progressive loss of T-cell function (day 7 vs day 28 mean specific lysis: 88.4% vs 8.6%; n = 6; P = .0003). Treatment-free intervals (TFIs), achieved by AMG 562 withdrawal, were identified as a powerful strategy for counteracting exhaustion. TFIs induced strong functional reinvigoration of T cells (continuous vs TFI-specific lysis on day 14: 34.9% vs 93.4%; n = 6; P &amp;lt; .0001) and transcriptional reprogramming. Furthermore, use of a TFI led to improved T-cell expansion and tumor control in\u00a0vivo. Our data demonstrate the relevance of T-cell exhaustion in bispecific antibody therapy and highlight that T cells can be functionally and transcriptionally rejuvenated with TFIs. In view of the growing number of bispecific molecules being evaluated in clinical trials, our findings emphasize the need to consider and evaluate TFIs in application schedules to improve clinical outcomes.<\/jats:p>","DOI":"10.1182\/blood.2022015956","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T15:05:52Z","timestamp":1658761552000},"page":"1104-1118","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":280,"title":["T-cell exhaustion induced by continuous bispecific molecule exposure is ameliorated by treatment-free intervals"],"prefix":"10.1182","volume":"140","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3918-7795","authenticated-orcid":false,"given":"Nora","family":"Philipp","sequence":"first","affiliation":[{"name":"1Department of Medicine III, University Hospital, Ludwig Maximilian University (LMU) Munich, Munich, Germany;"},{"name":"2Laboratory for Translational Cancer 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Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1956-2778","authenticated-orcid":false,"given":"Binje","family":"Vick","sequence":"additional","affiliation":[{"name":"3German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany;"},{"name":"4Helmholtz Zentrum M\u00fcnchen, German Research Center for Environmental Health (HMGU), Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Wulf","sequence":"additional","affiliation":[{"name":"1Department of Medicine III, University Hospital, Ludwig Maximilian University (LMU) Munich, Munich, Germany;"},{"name":"2Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Straub","sequence":"additional","affiliation":[{"name":"5Bioinformatics Unit, Biomedical Center, LMU Munich, Martinsried, 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