Tcellsterapi

Tcellsterapi, or T cell therapy, is a class of cancer immunotherapies that engineer or mobilize T lymphocytes to target tumor cells. The approach includes autologous therapies, where a patient's own T cells are collected, modified, expanded, and reinfused, and allogeneic therapies, which use donor T cells.

Common modalities are CAR-T cell therapy, in which T cells are modified to express chimeric antigen receptors that recognize surface antigens independent of MHC; TCR-T therapy, where T cells are engineered to express specific T cell receptors that recognize intracellular or peptide antigens presented on MHC; and tumor-infiltrating lymphocyte therapy, which expands T cells extracted from the tumor.

Manufacturing involves leukapheresis, genetic modification (viral or non-viral vectors), expansion, quality control, and mild lymphodepleting conditioning before infusion. Patients may receive bridging therapy to control disease during manufacturing. Side effects include cytokine release syndrome and neurotoxicity; other risks include graft-versus-host disease for allogeneic products and on-target off-tumor effects; management requires specialized care.

Approved indications vary by region. In the United States and EU, several CAR-T products have been approved for certain hematologic cancers, with ongoing trials in solid tumors. Research areas include improving efficacy, reducing toxicities, overcoming antigen loss, and extending applicability to a broader range of cancers and possibly infectious diseases.

Ethical and regulatory considerations address safety, manufacturing complexity, cost, and equitable access. Ongoing development includes improvements in targeting, off-the-shelf allogeneic products, and combination strategies with other therapies.