Strategies for having a more effective and less toxic CAR T-cell therapy for acute lymphoblastic leukemia.
Mohadese Hashem BoroojerdiFatemeh RahbarizadehPouya Safarzadeh KozaniElahe KamaliPooria Safarzadeh KozaniPublished in: Medical oncology (Northwood, London, England) (2020)
In the recent years, using genetically modified T cells has been known as a rapid developing therapeutic approach due to the heartwarming results of clinical trials with patients suffering from relapsed or refractory (R/R) hematologic malignancies such as R/R Acute Lymphoblastic Leukemia (R/R ALL). One of these renowned approaches is Chimeric antigen receptors (CARs). CARs are synthetic receptors with the ability to be expressed on the surface of T lymphocytes and are specifically designed to target a tumor-associated antigen (TAA) of interest. CAR-expressing T cells have the capability of proliferating and maintaining their immunological functionality in the recipient body but like any other therapeutic approach, the safety, effectiveness, and specificity enhancement of CAR T cells still lingers in the ambiguity arena. Genetic manipulation methods, expansion protocols, infusion dosage, and conditioning regimens are all among crucial factors which can affect the efficacy of CAR T cell-based cancer therapy. In this article, we discuss the studies that have focused on various aspects that affect the efficacy and persistence of CAR T-cell therapy for ALL treatment and provide a widespread overview regarding the practical approaches capable of elevating the effectiveness and lessening the relative toxicities attributed to it.
Keyphrases
- acute lymphoblastic leukemia
- cell therapy
- cancer therapy
- clinical trial
- randomized controlled trial
- allogeneic hematopoietic stem cell transplantation
- end stage renal disease
- stem cells
- systematic review
- ejection fraction
- newly diagnosed
- mesenchymal stem cells
- prognostic factors
- peritoneal dialysis
- chronic kidney disease
- drug delivery
- genome wide
- acute myeloid leukemia
- patient reported outcomes
- combination therapy
- gene expression
- hodgkin lymphoma
- open label
- phase iii
- double blind