Once attached, genetically modified T cells can kill cancer cells in the same way they kill other disease-causing cells. There are seven approved CAR T cell therapies, which are listed below in the order in which they were approved. All are approved for specific types of blood cancer. A number of CAR T-cell therapy products have been approved for use in a number of different malignancies, such as LBCL, B-ALL, and the MM.
The development of CAR T cells has dramatically changed the treatment of several hematologic malignancies and, with longer follow-up, may be curative for a subgroup of patients. For many patients undergoing treatment with CAR-T, this therapy provides significant long-term remissions and, most importantly, allows them to enjoy a good quality of life. The addition of a suicide gene to CAR-T cells leads to the selective destruction of adoptively transferred cells, as well as to the selective ablation of genetically modified cells, which avoids the unwanted effect of CAR-T therapy and the toxicity of the therapy. The remarkable results of CAR-T cell therapy were considered a clinical success; however, from a commercial perspective, CAR-T therapy has had minimal success.
While CD19 and BCMA are the only antigens for which there are FDA-approved CAR T cell therapies, CAR T cell therapies have been developed that target other antigens commonly found in blood cancers, including therapies that target several antigens at once. CAR-T therapy is currently the most effective therapy for approved indications, but the cell-killing capacity of cells is not limited to cancer cells alone. This review will demonstrate the challenges of CAR-T cell therapy in the treatment of cancer and will propose possible strategies for optimizing CAR cell therapy.
