The review identifies modulation of cell-intrinsic signaling pathways as a major strategy for improving CAR-T performance. In the abstract, this strategy is linked to persistence and exhaustion-related bottlenecks.
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modulation of cell-intrinsic signaling pathways
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The review summarizes adapter CAR systems, Boolean-logic gating, epitope editing, modulation of cell-intrinsic signaling pathways, safety switches, and co-stimulatory domain selection as main approaches to address CAR-T bottlenecks.
Antigen escape variants, off-tumor destruction of healthy tissues expressing tumor-associated antigens, poor CAR-T cell persistence, and functional exhaustion are prominent hurdles limiting long-lasting remissions with tolerable adverse effects.
CAR-engineered T-cell therapy has achieved unprecedented response rates in some hematological malignancies but remains far from fulfilling its potential, especially in solid cancers.