CAR T cell therapy involves the infusion of T cells that have been genetically engineered to express a chimeric antigen receptor (CAR) to reprogram the T cells. The CAR combines the specificity of a monoclonal antibody with the cytotoxic and memory functions of T cells.1
CAR specificity comes from the extracellular domain, which is derived from the antigen-binding site of a monoclonal antibody.2,3 The intracellular domain attempts to recapitulate the normal series of events by which T cells are activated and incorporates stimulatory and costimulatory domains, such as CD28 or 4-1BB (CD137), to augment CAR T cell survival and proliferation.1,4-6
Because CAR T cells carry their own co-stimulatory signaling, they may be less susceptible than unmodified T cells to negative regulation from tumors.1 Unlike T cell receptors, CAR T cells do not rely on dendritic cell antigen processing and presentation.7 In addition, CAR T cells may multiply and differentiate into central or effector memory cells, and have been observed to persist in the body for 30 days up to four years after administration.6,8,9
Autologous CAR T cell therapies are created from the patient’s own T cells. The production processes used to create CAR T cell therapies are specific to each manufacturer, making each CAR T cell therapy unique.