CARTZellen

CARTZellen, or CAR-T cells, are a form of immunotherapy in which a patient’s T cells are collected, engineered to express chimeric antigen receptors (CARs) that recognize specific tumor-associated antigens, and returned to the patient to target cancer cells. The CAR typically fuses an antigen-binding domain, usually a single-chain variable fragment derived from an antibody, with hinge and transmembrane regions and intracellular signaling domains. The inclusion of a costimulatory domain, such as CD28 or 4-1BB, promotes T-cell activation, expansion, and persistence. By enabling T cells to recognize antigens independently of HLA presentation, CAR-T cells can attack malignant cells that evade conventional T-cell recognition.

Manufacturing involves leukapheresis to collect T cells, genetic modification to express the CAR (commonly with viral vectors or non-viral methods), expansion to therapeutic doses, and quality control. Before infusion, patients often receive lymphodepleting chemotherapy to improve CAR-T cell engraftment. Most CAR-T products are autologous, using each patient’s own cells, though research into allogeneic, off-the-shelf CAR-T cells is advancing.

Clinical use has focused on hematologic cancers, particularly B-cell malignancies driven by CD19. Several CD19-targeted CAR-T therapies have obtained regulatory approvals in different regions, and additional products target other antigens such as BCMA for multiple myeloma. Ongoing trials are evaluating efficacy in broader indications, including solid tumors and earlier lines of therapy.

Safety concerns include cytokine release syndrome and neurotoxicity, which may require supportive care or immunomodulatory treatment. Other risks include prolonged cytopenias, infection, and potential relapse due to antigen loss. Challenges to widespread use include manufacturing complexity, cost, and logistics, as well as variable durability of response.