In vivo chimeric antigen receptor (CAR)-T cell therapy.

Area of Science:

• Immunotherapy
• Cellular Therapy
• Genetic Engineering

Background:

• Chimeric antigen receptor (CAR)-T cell therapy has revolutionized hematological cancer treatment.
• Current ex vivo CAR-T cell therapy faces challenges in manufacturing, scalability, and clinical consistency.

Purpose of the Study:

• To review advances in in vivo CAR-T cell engineering.
• To explore technologies enabling in vivo CAR-T cell generation.
• To discuss the potential of in vivo approaches for broader therapeutic applications.

Main Methods:

• Utilizing targeted delivery systems like lentiviral vectors and lipid nanoparticles.
• Introducing CAR-encoding genetic material into endogenous T cells within the patient.
• Leveraging advances in virology, RNA medicines, and nanotechnology.

Main Results:

• Early clinical studies demonstrate efficient T cell transduction and sustained CAR expression.
• Initial evidence of antitumour activity establishes proof of concept for in vivo CAR-T generation.
• In vivo engineering eliminates the need for ex vivo cell processing and conditioning.

Conclusions:

• In vivo CAR-T cell engineering offers a scalable and potentially more effective alternative to ex vivo methods.
• This strategy could expand CAR-T cell therapy applications beyond hematological malignancies to autoimmune diseases.
• Technological advancements are driving the development of safer and more broadly applicable in vivo CAR-T cell therapies.