Chimeric Antigen Receptor (CAR) T Cells: A Detailed Review of Origins, Engineering, and Therapeutic Impact

CAR T cell therapy is a groundbreaking immunotherapeutic approach that harnesses genetically engineered T cells to target and destroy cancer cells with specificity and potency. Emerging from decades of immunological and genetic engineering advances, CAR T cells represent a paradigm shift in cancer treatment, especially for hematologic malignancies refractory to conventional therapies. This review provides an in-depth analysis of the scientific and clinical evolution of CAR T cells, starting from the fundamental need for novel cancer therapies, through the detailed molecular structure of CAR constructs, to the complexities of manufacturing and clinical deployment. Applications in hematologic and solid tumors, challenges such as toxicity and tumor escape, and innovations in next-generation CAR designs are discussed. This comprehensive examination aims to contextualize CAR T cells within immunotherapy and inform future research directions.