Summary
Patient T cells are engineered with chimeric receptors to recognise and kill cancer cells.
In depth
T cells are collected, engineered with a receptor fusing an antibody fragment to T cell signalling domains, expanded and infused. Highly effective in B cell leukaemias and lymphomas; risks include cytokine release syndrome and neurotoxicity. Solid tumours are harder.
Costs are high; manufacturing takes weeks. Solid tumours are hard due to antigen heterogeneity and a hostile microenvironment. Allogeneic off-the-shelf products are being developed.
Example: CAR-T trials also target lupus.
The CAR has an extracellular antibody fragment (scFv), a transmembrane domain and intracellular signalling domains (CD3 zeta plus CD28 or 4-1BB). Approved products target CD19 for B cell leukaemia and lymphoma (tisagenlecleucel, axicabtagene), and BCMA for myeloma. Remission rates in refractory childhood acute lymphoblastic leukaemia reached 80 to 90 percent. Persistence of cells provides lasting surveillance.
Risks include cytokine release syndrome, neurotoxicity, B cell aplasia and relapse through loss of the antigen. Manufacturing is complex and costly, which has led to work on off-the-shelf allogeneic cells. Solid tumours are harder because of antigen heterogeneity and the suppressive microenvironment.
Example: Emily Whitehead, a girl treated in 2012 for leukaemia, remained in remission, becoming a milestone case.
Frequently asked questions
What is CAR-T Cell Therapy?
Patient T cells are engineered with chimeric receptors to recognise and kill cancer cells.
Which area of biology covers CAR-T Cell Therapy, and how advanced is it?
CAR-T Cell Therapy is one of the 52 topics in Immunology & Disease. It is rated Advanced, so it suits learners who want specialist depth. Related topics in this area include Immune Checkpoint Therapy, Monoclonal Antibodies, Natural Killer Cells.
Can you give an example of CAR-T Cell Therapy?
Tisagenlecleucel targets CD19.
What should I learn before CAR-T Cell Therapy?
Work through the Beginner topics in Immunology & Disease first, such as Immune System, Viruses, Innate Immunity, then return to CAR-T Cell Therapy. Advanced topics assume the Intermediate vocabulary.
What topics are related to CAR-T Cell Therapy?
The closest topics to CAR-T Cell Therapy are Immune Checkpoint Therapy, Monoclonal Antibodies, Natural Killer Cells, Cytokines. Comparing them side by side is a good way to see how the ideas connect.
How can I check that I understand CAR-T Cell Therapy?
Read the summary and the in-depth section, then use the quick check on the interactive lesson for CAR-T Cell Therapy. To practise the whole of Immunology & Disease, use the Immunology & Disease quiz.
How is CAR-T Cell Therapy different from Immune Checkpoint Therapy?
CAR-T Cell Therapy: Patient T cells are engineered with chimeric receptors to recognise and kill cancer cells. Immune Checkpoint Therapy: Drugs blocking inhibitory receptors such as PD-1 release T cells to attack tumours. Read both side by side and note what each one explains.
How should I study CAR-T Cell Therapy step by step?
First, read the summary and write the definition in your own words. Second, read the in-depth section and note any example. Third, compare it with Immune Checkpoint Therapy and explain the difference aloud. Finally, take the Immunology & Disease quiz and come back to this page for any question you miss.