Current status and optimization of CAR-T therapy in hematological malignancies

Chimeric antigen receptor T (CAR-T)therapy has reflected unprecedented success in treatment of hematological malignancies. It has been widely adopted as well. Moreover, there are continuously more therapeutic targets being explored. Though successful, CAR-T therapy has also presented limitations that might be fatal, such as cytokine release syndrome (CRS) and patient relapse. Patient relapse can be mainly attributed to antigen loss, which can be dealt with by several innovative methods. Other than the above drawbacks, CAR-T cell therapy is criticized of its high cost as it is a personlized therapy. To deal with this problem, universal CAR-T cells are under exploration and development, which can greatly reduce the cost of the therapy. This review will focus on the current drawbacks of CAR-T cell therapy in hematological malignancies, such as toxicity, relapse and unaffordable costs involved, and present some corresponding practical methods to mitigate them. In the wider application of CAR-T cell therapy, more problems and obstacles will be faced in the future. Innovative therapies are urgently needed to alleviate its defects and relapse risks, while methods to reduce costs should continue to be explored.