The Promise of Chimeric Antigen Receptor T-Cell Therapy

Chimeric antigen receptors (CARs) are engineered molecules that can be introduced into T cells to enable them to target specific tumor antigens. CAR T cells targeting CD19 have shown promise in patients with relapsed and refractory B-cell neoplasms, including those with acute lymphoblastic leukemia, chronic lymphocytic leukemia, and non-Hodgkin lymphomas. Notably, durable responses have been observed in patients who had not undergone consolidative stem cell transplant, a finding that correlates with reports of T-cell persistence and B-cell aplasia in studies of anti-CD19 treatment in vivo. Cytokine release syndrome, correlating with activation and expansion of T cells, and neurologic toxicity are the most significant treatment-related adverse effects. Efforts are underway to extend the benefits of immunotherapy with anti-CD19 CAR T cells to other targets and tumor types.