Fig. 2
From: The landscape of bispecific T cell engager in cancer treatment
Summary of currently identified mechanisms of tumor evasion to BiTE therapy. A. Loss of antigen---possible mechanisms: a. Lineage switch associated with 1) Gene rearrangement 2) Selective pressure due to bispecific T cell engager (BiTE) therapy b. Decreased or suppressed antigen expression associated with 1) Antigen mutation 2) Low RNA levels 3) Disrupted antigen trafficking process c. Alteration of antigen structure associated with 1) Antigen mutation 2) Alternative spicing B. Immunosuppressive tumor microenvironment (TME)---possible mechanisms: a. Immunosuppressive receptors such as PD-1/PD-L1 axis b. Immunosuppressive immune cells such as T regular (Treg) cells and MDSCs: Myeloid-derived suppressor cells; PD-1: Programmed cell death 1; PD- L1: Programmed cell death 1 ligand 1