Abstract
Chimeric antigen receptor (CAR) T-cells (CAR T-cells) are a promising therapeutic approach in treating hematological malignancies. CAR T-cells represent engineered autologous T-cells, expressing a synthetic CAR, targeting tumor-associated antigens (TAAs) independent of major histocompatibility complex (MHC) presentation. The most common target is CD19 on B-cells, predominantly used for the treatment of lymphoma and acute lymphocytic leukemia (ALL), leading to approval of five different CAR T-cell therapies for clinical application. Despite encouraging clinical results, treatment of other hematological malignancies such as acute myeloid leukemia (AML) remains difficult. In this review, we focus especially on CAR T-cell application in different hematological malignancies as well as strategies for overcoming CAR T-cell dysfunction and increasing their efficacy.
Highlights
In cell-mediated immune responses, T-lymphocytes (T-cells) play a pivotal role in surveilling and eliminating tumor cells or pre-malignant cells
The first application field of Chimeric antigen receptor (CAR) T-cell therapy has been hematological malignancies like acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) since they are easier to target than solid cancers in regard to finding an adequate tumor antigen [8,9]
CAR T-cell therapy is mainly performed in the context of hematological malignancies, but an increasing number of trials are conducted in solid tumor pamalignancies, but an increasing number of trials are conducted in solid tumor patients (Figure 1; clinicaltrials.gov) [12]
Summary
In cell-mediated immune responses, T-lymphocytes (T-cells) play a pivotal role in surveilling and eliminating tumor cells or pre-malignant cells. As a part of this, CAR T-cell therapy is a relatively new treatment option, based on reprogramming a patient’s own T-cells with a CAR construct and returning them into the patient’s blood, where they start to attack cancer cells [3]. The first application field of CAR T-cell therapy has been hematological malignancies like ALL, chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) since they are easier to target than solid cancers in regard to finding an adequate tumor antigen [8,9]. In March this year, an anti-BCMA CAR Tproved by the food and drug administration (FDA), four of them targeting CD19, the most cell therapy (Idecabtagene viclaucel) forthis theyear, treatment of multiple myeloma frequently used antigen. Therapies, therapies, will undoubtedly the field of autologous which will undoubtedly change the field of autologous T-cell immunotherapy
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