CAR = chimeric antigen receptor

individualized treatment against cancer

patients T cells are reprogrammed

CAR is expressed to fight cancer cells

  • to kill cancer cells: which specific antigens are only on cancer cells?
  • CAR T are modified to detect cancer-specific antigens. they express chimeric antigen receptors that match antigen on tumor.

How are CAR T cells made?

  1. Isolate T cells from blood of patient
  2. Genetically modify T cell to incorporate CAR gene
    1. can use viral vectors e.g. lentivirus
    2. transduction: virus inserts CAR gene
    3. CAR (protein, receptor) is produced on surface of T cell CAR T cell is born!
  3. CAR T cell population/growth happens in vitro
  4. CAR T cells infused back into patient
  5. CAR T cells patrol body and kill tumor cells w/ antigen that matches CAR
    1. Once the CAR recognizes the antigen, can trigger downstream pathways to kill the tumor, e.g. cytokine release, granzyme/perforin, FAS and FAS ligand

Key criteria for good CAR targets

  • surface expression on tumor (CARs can’t target intracellular proteins)
  • high expression level on cancer cells (ideal: uniquely expressed on cancer cells)
  • limited/no expression on vital normal tissues
  • essential for cancer cell survival (to prevent antigen escape)

Challenge: most tumor antigens are also expressed (albeit at lower levels) on some normal tissues, e.g.

  • BCMA (target for multiple myeloma) is also on plasma cells
  • GD2 (neuroblastoma target) is on peripheral nerves
  • HER2 (breast cancer target) is on cardiac cells

videos to watch