Combination of CRISPR/Cas9 System and CAR-T Cell Therapy: A New Era for Refractory and Relapsed Hematological Malignancies

Curr Med Sci. 2021 Jun;41(3):420-430. doi: 10.1007/s11596-021-2391-5. Epub 2021 Jul 3.

Abstract

Chimeric antigen receptor T (CAR-T) cell therapy is the novel treatment strategy for hematological malignancies such as acute lymphoblastic leukemia (ALL), lymphoma and multiple myeloma. However, treatment-related toxicities such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) have become significant hurdles to CAR-T treatment. Multiple strategies were established to alter the CAR structure on the genomic level to improve efficacy and reduce toxicities. Recently, the innovative gene-editing technology-clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated nuclease9 (Cas9) system, which particularly exhibits preponderance in knock-in and knockout at specific sites, is widely utilized to manufacture CAR-T products. The application of CRISPR/Cas9 to CAR-T cell therapy has shown promising clinical results with minimal toxicity. In this review, we summarized the past achievements of CRISPR/Cas9 in CAR-T therapy and focused on the potential CAR-T targets.

Keywords: chimeric antigen receptor T cell treatment; clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated nuclease9; gene editing; hematologic malignancy; immunotherapy.

Publication types

  • Review

MeSH terms

  • CRISPR-Cas Systems / genetics*
  • Cell- and Tissue-Based Therapy / trends
  • Gene Editing
  • Hematologic Neoplasms / genetics
  • Hematologic Neoplasms / pathology
  • Hematologic Neoplasms / therapy*
  • Humans
  • Immunotherapy / trends
  • Immunotherapy, Adoptive / trends*
  • Receptors, Chimeric Antigen / genetics*

Substances

  • Receptors, Chimeric Antigen