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Wilms' tumor 1 (WT1) is a zinc-finger transcription factor that is highly overexpressed in various hematological malignancies and solid tumors, while its expression in normal adult tissues is restricted to specific sites like the kidney podocytes and hematopoietic stem cells (Rosenfeld et al., 2003, Blood). The WT1-derived peptide ALLPAVPSL (residues 126-134) is a well-characterized immunogenic epitope that is processed and presented on the cell surface by the Human Leukocyte Antigen (HLA)-A*02:01 molecule (Oka et al., 2004, Journal of Clinical Oncology). This peptide-MHC (pMHC) complex serves as a specific target for advanced immunotherapies, including peptide vaccines, T-cell receptor (TCR) engineered T-cells, and TCR-like monoclonal antibodies such as ESK1 (Dao et al., 2013, Science Translational Medicine). These therapeutic approaches aim to exploit the differential expression of WT1 to induce a targeted immune response against cancer cells. Clinical trials have focused on using this target for treating acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), and various solid tumors, with patient selection typically requiring both WT1 expression and HLA-A*02:01 positivity.
T-cell receptor (TCR) mediated recognition of the peptide-MHC complex leading to cytotoxic T-lymphocyte (CTL) activation and tumor cell lysis.
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