Introduction to CART-Cell Therapy: Principles and Applications

CAR-T cell immunotherapy involves the genetic modification of T lymphocytes to express a chimeric antigen receptor, enabling them to recognize tumor cells. There are five generations of CARs, and the production process of these cells involves several stages: collection, genetic modification, cell expansion, and subsequent infusion into the patient. This therapy can cause Cytokine Release Syndrome and neurotoxic events, which are both manageable and treatable. Its greatest efficacy has been observed in treating hematological tumors, with CD-19 and BCMA targets approved for four tumor types, though challenges related to antigen escape and relapses remain. In solid tumors, the immunosuppressive microenvironment, heterogeneity, and antigen escape present challenges to the efficacy of immunotherapy, which are being addressed with new CAR designs. CAR-T cell therapy is revolutionizing the treatment of hematological cancers, with ongoing advancements in genetic engineering and strategic collaborations, promising significant improvements despite the challenges in solid tumors. Thus, this literature review aims to cover the key concepts of CAR-T therapy, providing an overview of its current applications and the main challenges to be addressed.