CAR T cells: engineered immune cells to treat brain cancers and beyond

Mol Cancer. 2023 Jan 31;22(1):22. doi: 10.1186/s12943-022-01712-8.

Abstract

Malignant brain tumors rank among the most challenging type of malignancies to manage. The current treatment protocol commonly entails surgery followed by radiotherapy and/or chemotherapy, however, the median patient survival rate is poor. Recent developments in immunotherapy for a variety of tumor types spark optimism that immunological strategies may help patients with brain cancer. Chimeric antigen receptor (CAR) T cells exploit the tumor-targeting specificity of antibodies or receptor ligands to direct the cytolytic capacity of T cells. Several molecules have been discovered as potential targets for immunotherapy-based targeting, including but not limited to EGFRvIII, IL13Rα2, and HER2. The outstanding clinical responses to CAR T cell-based treatments in patients with hematological malignancies have generated interest in using this approach to treat solid tumors. Research results to date support the astounding clinical response rates of CD19-targeted CAR T cells, early clinical experiences in brain tumors demonstrating safety and evidence for disease-modifying activity, and the promise for further advances to ultimately assist patients clinically. However, several variable factors seem to slow down the progress rate regarding treating brain cancers utilizing CAR T cells. The current study offers a thorough analysis of CAR T cells' promise in treating brain cancer, including design and delivery considerations, current strides in clinical and preclinical research, issues encountered, and potential solutions.

Keywords: Brain cancer; CAR T cells; Clinical trials; Hematological cancer; Immunotherapy; Solid tumors; Tumor antigen.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adaptor Proteins, Signal Transducing
  • Antibodies
  • Antigens, CD19
  • Brain Neoplasms* / therapy
  • Cell Death
  • Humans
  • Immunotherapy, Adoptive*
  • Receptors, Chimeric Antigen
  • T-Lymphocytes

Substances

  • Adaptor Proteins, Signal Transducing
  • Antibodies
  • Antigens, CD19
  • Receptors, Chimeric Antigen