CAR-T cell therapy and its engineering marvels in cancer immunotherapy: a comprehensive review

Abstract

Immunotherapy has emerged as a promising approach in the treatment of various malignancies, with adoptive cell therapy (ACT) showcasing significant efficacy. Among the diverse spectrum of ACT, Chimeric Antigen Receptor T-cell (CAR-T) therapy stands out as a groundbreaking modality, revolutionizing cancer treatment paradigms. This thesis delves into the intricate domains of CAR design, elucidating the structural components crucial for target specificity and efficacy. Insights into the administration process ensure a comprehensive understanding of the therapeutic protocol. The Mechanism of Action (MOA) of CAR-T therapy is expounded upon, unraveling the intricate signaling cascades that culminate in tumor cell destruction. Classification based on generation highlights the evolution and refinement of CAR-T technologies, while sophisticated approaches in CAR-T therapies explore strategies to enhance efficacy and mitigate adverse effects. Accessible-approved CAR-T therapies are scrutinized, emphasizing their clinical impact and therapeutic potential. Clinical trials and their implications shed light on ongoing research endeavors. Along with the discussed advantages, a section on the disadvantages of CAR-T therapy provide a balanced perspective on its clinical utility, while prominent targetable antigens delineate the antigenic landscape of this therapy for further future development. This thesis endeavors to provide a holistic understanding of CAR-T therapy, its challenges, and its transformative potential in the realm of cancer immunotherapy.