CAR T-Cells

Abstract

CAR-T (chimeric antigens receptor-T) cell therapy is a breakthrough therapy of the twenty-first century for the management of different malignancies including lymphomas and leukemias. Numeral trials are underway to understand the optimal CAR-T cell design and dose to maximize efficacy and mitigate toxicity. Currently two CAR-T cell therapy products, axicabtagene ciloleucel and tisagenlecleucel, are approved by the US Food and Drug Administration, which have shown excellent responses in otherwise poor prognostic lymphomas and leukemias. The favorable outcomes achieved of this therapy were noted to be durable during long-term follow-up. Understanding the challenges associated with manufacturing and the reasons for T cell failure including poor T cell expansion, persistence, and tumor resistance are critical for its wide-scale application in order to attain the full potential of this novel therapy. Here we review the salient features of the different CAR-T products and discuss the pivotal trials that led to its approval.

Keywords: Acute lymphoblastic leukemia; Axicabtagene ciloleucel; CAR T-cell; Cytokine-release syndrome; Diffuse large B-cell lymphoma; Follicular lymphoma; Immune effector cell-associated neurotoxicity syndrome; Immunotherapy; Lisocabtagene maraleucel; Siltuximab; Tisagenlecleucel; Tocilizumab.