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<p>Chimeric antigen receptor (CAR)&#xa0;T-cell therapy has revolutionized treatment of B‑cell cancers. Autologous T&#xa0;cells are genetically modified and returned as a&#xa0;“living drug”. Anti-CD19 CAR&#xa0;T-cell therapy is established for refractory B‑cell acute lymphoblastic leukemia and various B‑cell non-Hodgkin lymphomas. Moreover, in treatment-refractory multiple myeloma, anti-BCMA CAR&#xa0;T&#xa0;cells can achieve long-lasting disease control. Current studies explore first-line use, early molecular relapse, and novel designs (e.g., bispecific CARs). Key challenges include manufacturing time and logistics, which may be simplified in the future by allogeneic cells or in vivo production. For solid tumors, barriers include stroma, antigen heterogeneity, and an immunosuppressive microenvironment. New strategies involve local delivery, novel targets, “armored” CARs, and combination regimens. Point-of-care manufacturing may reduce time and cost, but it faces regulatory hurdles.</p>

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Systemtherapien der Zukunft: CAR-T-Zellen

  • 期刊论文

  • 发表日期：

    2026年1月6日

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  • Fabian Müller,
  • Keven Hörster,
  • Bastian von Tresckow

摘要

Chimeric antigen receptor (CAR) T-cell therapy has revolutionized treatment of B‑cell cancers. Autologous T cells are genetically modified and returned as a “living drug”. Anti-CD19 CAR T-cell therapy is established for refractory B‑cell acute lymphoblastic leukemia and various B‑cell non-Hodgkin lymphomas. Moreover, in treatment-refractory multiple myeloma, anti-BCMA CAR T cells can achieve long-lasting disease control. Current studies explore first-line use, early molecular relapse, and novel designs (e.g., bispecific CARs). Key challenges include manufacturing time and logistics, which may be simplified in the future by allogeneic cells or in vivo production. For solid tumors, barriers include stroma, antigen heterogeneity, and an immunosuppressive microenvironment. New strategies involve local delivery, novel targets, “armored” CARs, and combination regimens. Point-of-care manufacturing may reduce time and cost, but it faces regulatory hurdles.