CAR T-cell therapy in autoimmune diseases: where are we and where are we going?
- PMID: 40157379
- DOI: 10.1016/S2665-9913(24)00377-1
CAR T-cell therapy in autoimmune diseases: where are we and where are we going?
Abstract
Chimeric antigen receptor (CAR)-based therapies developed for the treatment of haematological malignancies have recently been repurposed to treat refractory systemic autoimmune diseases. In this Review we critically discuss the current data available on the use of CAR-based therapy in systemic autoimmune diseases, the current challenges, and the potential next steps toward their implementation into clinical practice. Beyond the targeting of B cells via CD19, we discuss the advantages and potential pitfalls of targeting plasma cells (B-cell Maturation Antigen or CD138) and other non-immune targets, such as fibroblast activated protein, and of aiming to restore immune homeostasis using CAR T regulatory cells. Crucial points need to be addressed for CAR-based therapy to become a viable treatment option for patients with systemic autoimmune diseases.
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Conflict of interest statement
Declaration of interests MS is a consultant for AbbVie, Amgen, AstraZeneca, Biogen, Bristol Myers Squibb, Fresenius Kabi, Galapagos, Innate Pharma, Nordic Pharma, Novartis, and Sandoz. GN is a consultant for AbbVie, Novartis, Galapagos, and Amgen; received support for attending meetings from Amgen and UCB; participated on a data safety monitoring board and advisory board for Boehringer Ingelheim; and received grant funding from the French rheumatology society, Arthritis and Dreamer foundations, and Foundation for Research in Rheumatology. AM is a consultant for LFB, AstraZeneca, Bristol Myers Squibb, Galapagos, Boehringer Ingelheim, Fresenius Kabi, and Viatris; received support for attending meetings from Bristol Myers Squibb, Galapagos, Fresenius Kabi, and UCB; and received equipment from Viatris. AB is a consultant for Fresenius Kabi, Roche Chugai, GSK, AbbVie, Novartis, and Boehringer Ingelheim. DL is a consultant for Biocryst and CSL Behring; received honoraria and support for attending meetings from Biocryst; and received grants from Therakos and Servier. XM is a consultant for Bristol Myers Squibb, GSK, Novartis, Otsuka, and Pfizer. CR is a consultant and received honoraria from AbbVie, Amgen, AstraZeneca, GSK, Novartis, Pfizer, Sandoz, Biogen, Bristol Myers Squibb, Galapagos, and Lilly; received a grant from Nordic Pharma; and received support for attending meetings from Celltrion, Amgen, AstraZeneca, and Galapagos. DC received research grants from Novartis, GSK, Servier, Bristol Myers Squibb, Roche-Chugai, CSL Behring, and AstraZeneca; is a consultant for Novartis, GSK, Bristol Myers Squibb, AstraZeneca, Amgen, Innate Pharma; and received support for attending meetings from Novartis, GSK, Bristol Myers Squibb, AstraZeneca, and Amgen. SC is a consultant and received honoraria from Novartis, Pierre Fabre, Atara, Janssen, Takeda, Gilead-Kite, AstraZeneca, Beigene, and Amgen. JA is a consultant and received honoraria from Bristol Myers Squibb and Novartis. All other authors declare no competing interests.
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