Bispecific CAR T-cells for B-cell Malignancies

Nurses' roles in CAR-T therapy for B-cell malignancies and managing associated cytokine release syndrome

“…While it has been established that CAR-T therapy has revolutionized the treatment of certain cancers, including B-cell cancers, serious side effects and relapse remain significant barriers to compliance and long-term survival. 12 The widespread implementation of CAR-T therapy is encumbered by several obstacles, including antigenic evasion, uneven intratumoral infiltration in solid cancers, cytokine release syndrome (CRS), neurotoxicity, logistical implementation, and a financial burden. 13 As in all other cancer treatments, CAR T therapies have been associated with unique adverse effects, including CRS and neurologic events (also known as immune effector cell–associated neurotoxicity syndrome [ICANS]), 14 with CRS generally occurring in the first week after CAR-T infusion and ICANS occurring in the second week after infusion.…”

Advancements in CAR-NK therapy: lessons to be learned from CAR-T therapy

“…Several strategies are under development to circumvent this limitation. Dual-specificity CAR-T cells capable of targeting two separate antigens have achieved strong complete response rates in clinical trials ( 112 – 115 ). Even then, relapses following the loss of at least one antigen have been observed ( 113 – 115 ).…”

“…Dual-specificity CAR-T cells capable of targeting two separate antigens have achieved strong complete response rates in clinical trials ( 112 – 115 ). Even then, relapses following the loss of at least one antigen have been observed ( 113 – 115 ). Longer follow up and larger trials are needed to determine if these strategies are truly beneficial in reducing relapse and what effect multi-antigen targeting has on CAR-T persistence.…”

Design and characterization of multiplex gene-edited CAR-T cells resistant to orthogonal immunosuppressive pathways within the solid tumor microenvironment

“…Other innovative approaches being actively investigated to improve the efficacy of CAR-T cell therapy in solid tumors including the use of oncolytic viruses to remodel the TME, enhancement of T cell trafficking into the TME, and the design of next-generation CARs, such as bispecific CARs, and inducible or switchable CARs [73][74][75][76]. The shift towards these complex engineering strategies illuminates the clear need to combine multiple therapeutic options to overcome the high tumoral defenses established by the TME.…”