4.8 Review

Challenges and Clinical Strategies of CAR T-Cell Therapy for Acute Lymphoblastic Leukemia: Overview and Developments

Journal

FRONTIERS IN IMMUNOLOGY
Volume 11, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2020.569117

Keywords

CAR T-cell; application; challenges; access; adverse events; resistance; relapse; clinical strategies

Categories

Funding

  1. Clinical Research Startup Program of Southern Medical University by High-level University Construction Funding of Guangdong Provincial Department of Education [LC2016ZD027]
  2. Guangdong Science and Technology Department [2017A020215183]
  3. Major Program for Health Medical Collaborative Innovation of Guangzhou [201704020216]
  4. Natural Science Foundation of Guangdong Province, China [2018B030311042]
  5. Frontier Research Program of Guangzhou Regenerative Medicine and Health Guangdong Laboratory [2018GZR110105014]

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CAR T-cell therapy has shown promising efficacy in patients with acute lymphoblastic leukemia, but faces challenges in clinical application. Issues such as resistance, relapse, product accessibility, and infusion safety need to be addressed through further research and strategic approaches for successful development and utilization in clinical settings.
Chimeric antigen receptor (CAR) T-cell therapy exhibits desirable and robust efficacy in patients with acute lymphoblastic leukemia (ALL). Stimulated by the revolutionized progress in the use of FDA-approved CD19 CAR T cells, novel agents with CAR designs and targets are being produced in pursuit of superior performance. However, on the path from bench to bedside, new challenges emerge. Accessibility is considered the initial barrier to the transformation of this patient-specific product into a commercially available product. To ensure infusion safety, profound comprehension of adverse events and proactive intervention are required. Additionally, resistance and relapse are the most critical and intractable issues in CAR T-cell therapy for ALL, thus precluding its further development. Understanding the limitations through up-to-date insights and characterizing multiple strategies will be critical to leverage CAR T-cell therapy flexibly for use in clinical situations. Herein, we provide an overview of the application of CAR T-cell therapy in ALL, emphasizing the main challenges and potential clinical strategies in an effort to promote a standardized set of treatment paradigms for ALL.

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