CAR-T cell therapy is one of the newest and most successful methods for treating cancer. The therapy is based on transducing CAR receptors into patient's autologous T cells. CAR receptors are fusion proteins capable of recognising tumour antigens and activating lymphocyte T response. CAR receptors comprise of five typical domains: antigen-binding domain, extracellular spacer, transmembrane domain, signaling domain and costimulatory domain. Each of them has a specific function and affects how the CAR receptor and CAR-T cell therapy performs. Production of CAR-T cells is done in multiple steps. First, patient’s allogenic lymphocytes T are taken from his blood, then they are activated and transformed with CAR receptor gene, expanded and returned into the patient’s blood in a form of an infusion. After the infusion, the cells continue to proliferate in the patient and perform their function of attacking and killing tumour cells. Alongside the initial big success of the therapy for leukemias, there are some severe side effects of the therapy that need to be addressed. The biggest issues are cytokine release syndrome and on-target off tumour toxicities. Various solutions for the problems have arisen. The main two strategies are the use of suicide mechanisms that induce apoptosis in CAR-T cells when inductor molecule is administered, and the use of a combination of CAR receptors that is capable of distinguishing between heathy and cancerous cells.
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