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Challenges of driving CD30-directed CAR-T cells to the clinic
Natalie S Grover1, Barbara Savoldo2
1Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, 27599, USA. Natalie_grover@med.unc.edu.
Abstract:
Chimeric antigen receptor T (CAR-T) cells are a promising new treatment for patients with relapsed or refractory hematologic malignancies, including lymphoma. Given the success of CAR-T cells directed against CD19, new targets are being developed and tested, since not all lymphomas express CD19. CD30 is promising target as it is universally expressed in virtually all classical Hodgkin lymphomas, anaplastic large cell lymphomas, and in a proportion of other lymphoma types, including cutaneous T cell lymphomas and diffuse large B cell lymphomas. Preclinical studies with CD30-directed CAR-T cells support the feasibility of this approach. Recently, two clinical trials of CD30-directed CAR-T cells in relapsed/refractory CD30+ lymphomas, including Hodgkin lymphoma, have been reported with minimal toxicities noted and preliminary efficacy seen in a proportion of patients. However, improving the persistence and expansion of CAR-T cells is key to further enhancing the efficacy of this treatment approach. Future directions include optimizing the lymphodepletion regimen, enhancing migration to the tumor site, and combination with other immune regulators. Several ongoing and upcoming clinical trials of CD30-directed CAR-T cells are expected to further enhance this approach to treat patients with relapsed and refractory CD30+ lymphomas.
Insights
Chimeric antigen receptor T (CAR-T) cell therapy targeting CD30 shows promise for relapsed lymphomas. Ongoing trials aim to improve CAR-T cell persistence and efficacy for better patient outcomes.
Area of Science:
- Immunotherapy
- Oncology
- Hematology
Background:
- Chimeric antigen receptor T (CAR-T) cell therapy is a novel treatment for hematologic malignancies.
- CD19-targeted CAR-T cells have shown success, but alternative targets are needed for CD19-negative lymphomas.
- CD30 is expressed across various lymphoma subtypes, making it a viable target.
Purpose of the Study:
- To evaluate the feasibility and efficacy of CD30-directed CAR-T cell therapy.
- To explore CD30 as a therapeutic target for relapsed or refractory lymphomas.
- To identify strategies for enhancing CAR-T cell persistence and anti-tumor activity.
Main Methods:
- Preclinical studies assessing CD30-directed CAR-T cell activity.
- Clinical trials involving patients with relapsed/refractory CD30+ lymphomas.
- Analysis of treatment toxicities and preliminary efficacy.
Main Results:
- Preclinical data support the feasibility of CD30-CAR-T cell therapy.
- Early clinical trials demonstrate minimal toxicity and preliminary efficacy in a subset of patients.
- CD30-directed CAR-T cells offer a potential treatment option for lymphomas lacking CD19 expression.
Conclusions:
- CD30-directed CAR-T cell therapy is a promising approach for CD30-positive lymphomas.
- Enhancing CAR-T cell persistence and expansion is crucial for improved treatment outcomes.
- Future research will focus on optimizing treatment regimens and exploring combination therapies.
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