Introduction: Cancer is a major challenge to human health worldwide, and, while making some progress, traditional cancer treatments, such as chemotherapy, radiotherapy and surgery, often have a series of limitations and side effects (1). However, in recent years, chimeric antigen receptor (CAR)-T cell therapy, which is also known as the ‘living drug’, has emerged (2).
CAR-T cell therapy has garnered interest in the field of cancer treatment as a personalized cancer immunotherapy strategy (2,3). It works by altering the immune system of a patient, allowing it to recognize, attack and remove cancer cells (4). Among the immune system, CAR-T cells are a special subpopulation of T cells that are genetically engineered to express specific antigen receptors, and to effectively recognize and destroy cancer cells (5). However, this therapy also faces multifaceted challenges, such as antigen selection, treatment tolerance and safety .Tumor cells lacking specific antigens or displaying heterogeneity in antigen expression can impair the antigen selectivity of CAR-T cells (8)
Methods: First, doctors screen patients to determine if the patients are eligible to receive CAR-T cell therapy (51). This typically includes evaluating the disease type, stage of disease, physical health and immune system status of the patient (52). The peripheral blood of the patient is collected, and the T cells are isolated using centrifugation and immunomagnetic bead assay. In the laboratory, the T cells are genetically modified to introduce the CAR gene, which enables the T cells to recognize and attack specific tumor cells. The modified T cells are expanded and cultured in vitro to increase their number, which allows a sufficient number of CAR-T cells to be obtained for use in therapy
Results: Tisagenlecleucel (89) (Novartis International AG) and axicabtagene ciloleucel (89) (Kite Pharma; Gilead Sciences, Inc.) have been approved by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency. They are used for the treatment of relapsed/refractory B-NHL in adults (90). In addition, Tecartus™ (91) is a CAR-T cell therapy drug, developed by Gilead Sciences, Inc., for the treatment of relapsed/refractory B-ALL in adults (Table I). Bristol-Myers Squibb Company developed Breyanzi (lisocabtagene maraleucel) for the treatment of adult relapsed/refractory large B-cell lymphoma
Conclusion: CAR-T cell therapy is a revolutionary immunotherapy that has achieved notable success in treating a number of B cell-associated malignancies. By targeting specific antigens on the surface of tumors, CAR-T cells are able to identify and destroy malignant cells, providing a new treatment option for those patients for whom conventional therapies have failed. However, CAR-T cell therapy still faces a number of challenges and limitations. Serious adverse reactions, such as CRS and neurotoxicity, may occur during treatment