Faroogh Marofi1, Roza Motavalli2,3, Vladimir A Safonov4, Lakshmi Thangavelu5, Alexei Valerievich Yumashev6, Markov Alexander7, Navid Shomali8, Max Stanley Chartrand9, Yashwant Pathak10, Mostafa Jarahian11, Sepideh Izadi8, Ali Hassanzadeh8, Naghmeh Shirafkan8, Safa Tahmasebi8, Farhad Motavalli Khiavi12. 1. Department of Hematology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 2. Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Rozamotavalli@gmail.com. 3. Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Rozamotavalli@gmail.com. 4. The Laboratory of Biogeochemistry and Environment, Vernadsky Institute of Geochemistry and Analytical Chemistry of Russian Academy of Sciences, Kosygina 19 Street, Moscow, Russian Federation, 119991. 5. Department of Pharmacology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India. 6. Department of Prosthetic Dentistry, First Moscow State Medical University, Moscow, Russian Federation. 7. Tyumen State Medical University, Tyumen Industrial University, Tyumen, Russian Federation. 8. Toxicology and Chemotherapy Unit (G401), German Cancer Research Center, 69120, Heidelberg, Germany. 9. DigiCare Behavioral Research, Casa Grande, AZ, USA. 10. Taneja College of Pharmacy, University of South Florida, Tampa, FL, USA. 11. Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 12. Department of Virology, Pasteur Institute of Iran, Tehran, Iran. farhad.motavalli@gmail.com.
Abstract
BACKGROUND: CARs are simulated receptors containing an extracellular single-chain variable fragment (scFv), a transmembrane domain, as well as an intracellular region of immunoreceptor tyrosine-based activation motifs (ITAMs) in association with a co-stimulatory signal. MAIN BODY: Chimeric antigen receptor (CAR) T cells are genetically engineered T cells to express a receptor for the recognition of the particular surface marker that has given rise to advances in the treatment of blood disorders. The CAR T cells obtain supra-physiological properties and conduct as "living drugs" presenting both immediate and steady effects after expression in T cells surface. But, their efficacy in solid tumor treatment has not yet been supported. The pivotal challenges in the field of solid tumor CAR T cell therapy can be summarized in three major parts: recognition, trafficking, and surviving in the tumor. On the other hand, the immunosuppressive tumor microenvironment (TME) interferes with T cell activity in terms of differentiation and exhaustion, and as a result of the combined use of CARs and checkpoint blockade, as well as the suppression of other inhibitor factors in the microenvironment, very promising results were obtained from the reduction of T cell exhaustion. CONCLUSION: Nowadays, identifying and defeating the mechanisms associated with CAR T cell dysfunction is crucial to establish CAR T cells that can proliferate and lyse tumor cells severely. In this review, we discuss the CAR signaling and efficacy T in solid tumors and evaluate the most significant barriers in this process and describe the most novel therapeutic methods aiming to the acquirement of the promising therapeutic outcome in non-hematologic malignancies.
BACKGROUND:CARs are simulated receptors containing an extracellular single-chain variable fragment (scFv), a transmembrane domain, as well as an intracellular region of immunoreceptor tyrosine-based activation motifs (ITAMs) in association with a co-stimulatory signal. MAIN BODY: Chimeric antigen receptor (CAR) T cells are genetically engineered T cells to express a receptor for the recognition of the particular surface marker that has given rise to advances in the treatment of blood disorders. The CAR T cells obtain supra-physiological properties and conduct as "living drugs" presenting both immediate and steady effects after expression in T cells surface. But, their efficacy in solid tumor treatment has not yet been supported. The pivotal challenges in the field of solid tumor CAR T cell therapy can be summarized in three major parts: recognition, trafficking, and surviving in the tumor. On the other hand, the immunosuppressive tumor microenvironment (TME) interferes with T cell activity in terms of differentiation and exhaustion, and as a result of the combined use of CARs and checkpoint blockade, as well as the suppression of other inhibitor factors in the microenvironment, very promising results were obtained from the reduction of T cell exhaustion. CONCLUSION: Nowadays, identifying and defeating the mechanisms associated with CAR T cell dysfunction is crucial to establish CAR T cells that can proliferate and lyse tumor cells severely. In this review, we discuss the CAR signaling and efficacy T in solid tumors and evaluate the most significant barriers in this process and describe the most novel therapeutic methods aiming to the acquirement of the promising therapeutic outcome in non-hematologic malignancies.
Entities:
Keywords:
CAR T cells; Cell therapy; Chimeric antigen receptor; Solid tumors
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