Figure 8.

CAP-100 is a single molecule affecting both homed and circulating CLL cells. In CLL, CCR7 mediates migration and invasion to LN and other lymphoid organs. Here CCR7 also mediates positioning of tumor cells within protective niches where tumor cells find trophic factors, including CCL19 and CCL21. CAP-100 is presented as a novel and potential tool in the treatment of CLL due to its double and effective mechanism of action. CAP-100 blocks CLL cells in the bloodstream, preventing homing of CLL through HEV and afferents into lymphoid tissues where it also prevents tissue interactions with accessory cells or CCR7 cognate ligands. This way, CAP-100 forces accumulation of CLL cells in bloodstream where tumor cells are depleted by CAP-100 Fc-mediated immune effector mechanisms, and potentially by other drugs since CAP-100 activities suggest complementarity with other SOC in CLL. ADCC, antibody-dependent cell-mediated cytotoxicity; CDC, complement-dependent cytotoxicity; FC, fludarabine + cyclophosphamide; HEV, high endothelial venules; LN, lymph node; PC, proliferation center