Limitations in the CAR-T therapy for diffuse large B-cell lymphoma

Abstract

Diffuse large B-cell lymphoma (DLBCL) therapy has been the subject of much investigation for many years. CAR-T cell therapy (CAR-T therapy) is now a new treatment for DLBCL. Human T cells are genetically altered to create new CAR-T cells, which are then injected into patients' bodies to kill cancer cells via an immune reaction. This process is known as CAR-T therapy. When treating refractory/relapsing (r/r) DLBCL, CAR-T therapy has showed some fairly thrilling clinical responses in comparison to conventional therapy and has a high cure rate. A few CAR-T treatments for DLBCL have also been authorized and put on the market. CAR-T cell therapy, however, has several drawbacks and difficulties when used to treat DLBCL. Some individuals are resistant to the therapy, leading to unsuccessful treatment, for the immunosuppressive microenvironment (TME) of DLBCL tumors and the phenomena of antigen escape. Additionally, CAR-T cell treatment may have major adverse effects including CRS and ICANS. If these adverse effects are not taken into consideration, people might die. Additionally, CAR-T treatment is quite pricey and common people might not be able to afford it, which will lead to a number of ethical issues. Naturally, scientists are working to provide answers to these problems and have made some success. The fundamentals of CAR-T therapy and its drawbacks for treating DLBCL will be covered in this review (including drug resistance, side effects, ethical and financial issues). Of course, the corresponding solutions, such as developing multiple targeted CARs and inhibiting the activity of certain cytokines, will also be described in this review.