Advances in CAR-T cell therapy for refractory diseases: challenges, innovations, clinical breakthroughs, and future prospects

Abstract Chimeric antigen receptor-T (CAR-T) cell therapy has revolutionized cancer immunotherapy, enlightening new hope for patients with hematological malignancies and emerging potential in solid tumors and other refractory diseases. This review delves into the fundamentals, challenges, technological innovations, clinical breakthroughs, and future prospects of CAR-T cell therapy. It explores the mechanisms of action, evolution, key challenges such as toxicity and solid tumor resistance, recent technological advancements in CAR engineering, clinical breakthroughs in solid tumors and other refractory diseases, and future directions including next-generation constructs, gene editing, manufacturing scalability, and expansion beyond cancers. By synthesizing the latest research, this review aims to provide a comprehensive understanding of CAR-T cell therapy and its potential to transform cancer treatment and other therapeutic areas.