Overcoming Antigen Escape and T-Cell Exhaustion in CAR-T Therapy for Leukemia

Leukemia is a prevalent pediatric cancer with significant challenges, particularly in relapsed or refractory cases. Chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a personalized cancer treatment, modifying patients’ T cells to target and destroy resistant cancer cells. This study re...

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Main Authors: Elżbieta Bartoszewska, Maciej Tota, Monika Kisielewska, Izabela Skowron, Kamil Sebastianka, Oliwia Stefaniak, Klaudia Molik, Jakub Rubin, Karolina Kraska, Anna Choromańska
Format: Article
Language:English
Published: MDPI AG 2024-09-01
Series:Cells
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Online Access:https://www.mdpi.com/2073-4409/13/18/1596
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Summary:Leukemia is a prevalent pediatric cancer with significant challenges, particularly in relapsed or refractory cases. Chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a personalized cancer treatment, modifying patients’ T cells to target and destroy resistant cancer cells. This study reviews the current therapeutic options of CAR-T therapy for leukemia, addressing the primary obstacles such as antigen escape and T-cell exhaustion. We explore dual-targeting strategies and their potential to improve treatment outcomes by preventing the loss of target antigens. Additionally, we examine the mechanisms of T-cell exhaustion and strategies to enhance CAR-T persistence and effectiveness. Despite remarkable clinical successes, CAR-T therapy poses risks such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Our findings highlight the need for ongoing research to optimize CAR-T applications, reduce toxicities, and extend this innovative therapy to a broader range of hematologic malignancies. This comprehensive review aims to provide valuable insights for improving leukemia treatment and advancing the field of cancer immunotherapy.
ISSN:2073-4409