Understanding immunotherapy and CAR-T-cells: A narrative review

Abstract

This comprehensive narrative review aims to delve into the various aspects of immunotherapy, with a special focus on the role of chimeric antigen receptor T (CAR-T) cells in modern medical interventions. To strengthen the understanding of the foundations of immunotherapy, a detailed exposition of the mechanisms underpinning the normal human immune response has been provided, encompassing both innate and adaptive immunity, along with the pivotal role of immune cells in neoplastic surveillance and immune editing. Furthermore, the review elucidates various active and passive immunotherapeutic interventions, providing a thorough overview of various agents and their mechanisms of action. It also delves into the structure of CAR-T-cells, their signaling cascades, and the means to fine-tune their effector functions. In addition, the review briefly throws light on the diverse clinical applications of CAR-T-cells that extend beyond its infamous applications in oncology to diseases with high healthcare burdens, such as autoimmune disorders, HIV, and cardiac fibrosis. This holistic exploration of the current state of immunotherapy and the dynamic landscape of CAR-T-cell therapy thus underscores the promise of these advancements in shaping a patient-centric approach to disease management and treatment.