The ESA framework is presented as a comprehensive design framework for engineering next-generation Smart CAR-T cells. It organizes strategies around efficacy, safety, and accessibility.
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Efficacy, Safety, and Accessibility (ESA) framework
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ESA framework
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The review proposes an Efficacy, Safety, and Accessibility framework for engineering next-generation Smart CAR-T cells.
CAR-T therapy has achieved major success in hematological malignancies but faces major challenges in solid tumors.
Key solid-tumor limitations for CAR-T include on-target off-tumor toxicity, antigen heterogeneity, and an immunosuppressive tumor microenvironment with extracellular-matrix barriers to T-cell infiltration.
Integrating logic gates, conditional activation, allogeneic strategies, and AI/ML is presented as a new precision-immunotherapy paradigm for making CAR-T cells intelligent, controllable, and more accessible against complex solid tumors.