Improving CAR T-cells: The next generation

Andrew H. Marple, Challice L. Bonifant, Nirali N. Shah

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


The introduction of chimeric antigen receptor (CAR) T-cell therapy in acute lymphoblastic leukemia (ALL) has dramatically altered the landscape of treatment options available to children and adults with ALL. With complete remission induction rates exceeding 70% in most trials and FDA approval of one CD19 CAR T-cell construct in ALL, CAR T-cell therapy has become a mainstay in the ALL treatment algorithm for those with relapsed/refractory disease. Despite the high remission induction rate, with growing experience using CAR T-cell therapy in ALL, a host of barriers to maintaining long-term durable remissions have been identified. Specifically, relapse after, resistance to, or loss of long-term CAR T-cell persistence may all hinder CAR T-cell efficacy. In this review, we provide an overview of the current limitations which inform the design of the next generation of CAR T-cells and discuss advances in CAR T-cell engineering aimed to improve upon outcomes with CAR T-cell-based therapy in ALL.

Original languageEnglish (US)
Pages (from-to)115-121
Number of pages7
JournalSeminars in Hematology
Issue number3
StatePublished - Jul 2020


  • CAR T-cell therapy
  • Immunotherapy
  • Resistance

ASJC Scopus subject areas

  • Hematology


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