Chimeric Antigen Receptor (CAR) T-Cell Immunotherapy in Solid Tumours: Challenges and Coping Strategies

Abstract

Chimeric antigen receptor (CAR) T-cell therapy is an approved immunotherapy for heamatomatological malignancies that entails attaching laboratory-manufactured CARs to human T cells before injecting them into the patient to target cancerous cells. The impressive results in vitro and in vivo have intensified research on CAR T-cell therapy, which has seen rapid development and revolution in the heamatological malignant field, leading to the approval of four products by the United States Food and Drug Administration (USFDA) and subsequently approved in many countries, including the United Kingdom. However, CAR T-cell therapy has not attained the same success in solid tumours due to a multitude of factors, including the heterogeneity of tumour antigens, the immunosuppressive tumour microenvironment (TME), as well as the minimal numbers of trafficking and infiltration to solid tumours since they mostly accumulate in the bone marrow and lymphoid tissues. Although CAR T cells have a limited ability to flourish in solid tumours, research continues to improve their effectiveness, and promising results have been emerged recently, particularly in emerging tumours, which may provide a way to transcend their complicated biological environment and become one of the primary treatments. This research investigates barriers to CAR-T cell immunotherapy's success in solid tumours, proposes techniques to be overcome, on the other hand, touches on the financial and geographic limitations, and the future direction of CAR T-cell immunotherapy.