CAR-T therapy in non-small cell lung cancer: Clinical prospects, potential, and strategies for cardiotoxicity management

Lung cancer ranks first among all malignancies in incidence, with current treatment strategies including surgery, chemotherapy, immunotherapy, and targeted therapy. Despite these advances, drug resistance in advanced non-small cell lung cancer (NSCLC) remains a major obstacle and innovative therapeutic approaches are imperative to address it. Chimeric antigen receptor T-cell (CAR-T) therapy has shown impressive and long-lasting results in blood cancers, but its success in solid tumors such as lung cancer remains limited. This review summarizes recent advances and future directions of CAR-T therapy in NSCLC, focusing on major therapeutic targets such as EGFR, MSLN, PD-L1, MUC1, CEA, and ROR1, as well as on the efficacy and potential of combining CAR-T therapy with other treatment modalities. Additionally, we discuss adverse events in NSCLC patients undergoing CAR-T therapy, emphasizing cytokine release syndrome (CRS) and cardiovascular complications-their incidence, pathophysiology, interrelation, and management strategies.