EC Cardiology

Treatment of cancer, especially liquid tumors, is remarkably effective when T cells carrying chimeric antigen receptors (CARs) are used. The ability to develop CARs for specific oncological applications has made them a compelling alternative to established cancer therapies such as chemotherapy or radiation therapy. CAR T cells are engineered from T cells isolated from the patient’s or donor’s blood. The patient then receives a second infusion of the genetically altered, enlarged T cells. CARs comprise a transmembrane domain called the spacer domain, a single chain variable fragment (scFv), one or more cytoplasmic domains, and an extracellular ligand-binding domain, usually also an scFv. These CAR T cells are then tested against cancer. Based on their pharmacodynamic and pharmacokinetic characteristics, they can be classified as first, second, third, or fourth-generation CAR T cells. Each generation showed different efficacy and safety, showing that the primary step in ACT is carefully selecting target antigens. Six CAR-T cell therapies have been approved by the US Food and Drug Administration (FDA) so far for patients with aggressive hematologic malignancies, including non-Hodgkin lymphomas (NHL), two cases of B-cell acute lymphoblastic leukemia (B-ALL), and one case of multiple myeloma (MM). Many more CAR-T cell therapies are currently in the clinical development pipeline for these and other malignancies.

Keywords: Antigen Receptors; Chemotherapy; Genetic Alterations; Hematologic Malignancies; Oncological Applications; Radiation Therapy

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