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Updated: Feb 3, 2026

Studying Interactions between Myeloid Cells and CAR T Cells In Vitro and In Vivo
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Resisting CAR T-cell Therapy: A Case Study

    Cancer Discovery
    |October 28, 2018
    PubMed

    Insights

    A rare resistance mechanism to chimeric antigen receptor (CAR) T-cell therapy was observed. Accidental gene transfer masked the cancer target, hiding it from CAR T-cells.

    Area of Science:

    • Immunology
    • Oncology
    • Molecular Biology

    Background:

    • Chimeric antigen receptor (CAR) T-cell therapy is a promising cancer treatment.
    • Resistance to CAR T-cell therapy can limit treatment efficacy.

    Discussion:

    • A case report identified a novel resistance mechanism to anti-CD19 CAR T-cell therapy.
    • This resistance occurred due to accidental transduction of a leukemic B cell with the CAR19 gene during manufacturing.
    • The CAR19 protein on the B cell surface masked the CD19 target, preventing CAR T-cell recognition.

    Key Insights:

    • In cis epitope masking is a rare mechanism of CAR T-cell resistance.
    • This phenomenon highlights manufacturing-related risks in CAR T-cell therapy.
    • Understanding resistance mechanisms is crucial for improving CAR T-cell therapy outcomes.

    Outlook:

    • Further research is needed to explore the frequency and implications of in cis epitope masking.
    • Strategies to mitigate manufacturing-induced resistance should be investigated.
    • This finding may inform the development of next-generation CAR T-cell therapies.

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