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Chimeric Antigen Receptor T Cells: Clinical Applications, Advances and Challenges

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Advanced Concepts in Human Immunology: Prospects for Disease Control

Abstract

Chimeric antigen receptor (CAR) T cells have emerged as a potential groundbreaking treatment for patients with advanced B-cell and other hematologic malignancies. CAR T cells recognize and eliminate tumor cells via cytotoxic killing, independent of the major histocompatibility complex. They are predominantly used in the treatment of many leukemias and lymphomas, such as acute lymphoblastic leukemia, chronic lymphocytic leukemia, Non-Hodgkin lymphoma, and multiple myeloma, via the administration of CD19-targeted or BCMA-targeted CAR T cells respectively. Although there is strong clinical data to support the efficacy of this therapy, toxicity, relapse, and a lack of its broad application for solid tumors have emerged as challenges. In this section, we will highlight the application of CAR T cells in treating hematologic malignancies, as well as their application in solid tumors. Here, we will review the engineering of CAR T cells, clinical data on CD19 and BCMA CAR T cells, and limitations of these therapies. Additionally, we will discuss the development of novel approaches to engineer CAR T cells, identify target antigens, increase their effectiveness and mitigate toxicity. These advances will allow for progress of this therapy and help to overcome the hurdles that are currently present in the use of CAR T cells.

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Authors and Affiliations

  1. The Department of Medicine and Molecular and Cellular Biology and Genetics Program, Division of Infectious Diseases & HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, USA

    Margaret H. O’Connor

  2. Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, USA

    Kiran Madugula

  3. Department of Medicine and Immunology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Melody Smith

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  1. Margaret H. O’Connor
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  2. Kiran Madugula
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  3. Melody Smith
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Correspondence to Melody Smith .

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Editors and Affiliations

  1. Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA, USA

    Pooja Jain

  2. Department of Medicine-Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, USA

    Lishomwa C. Ndhlovu

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O’Connor, M.H., Madugula, K., Smith, M. (2020). Chimeric Antigen Receptor T Cells: Clinical Applications, Advances and Challenges. In: Jain, P., Ndhlovu, L. (eds) Advanced Concepts in Human Immunology: Prospects for Disease Control. Springer, Cham. https://doi.org/10.1007/978-3-030-33946-3_7

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