Crossing the threshold in clinical activity, chimeric antigen receptor-modified T cells
have emerged as a new effective therapeutic regimen against various types of cancer both in adults
and pediatric oncology. Currently available CARs are designed in a manner so that that they are
capable of recognizing MHC independent antigen and incorporate costimulatory signal, converting
the transduced T cells with potent activity. They have higher efficacy than monoclonal antibody
and antibody-drug conjugate. There are various generations of CAR-T cells depending upon
intracellular signalling domain number. CAR therapy maintained especial status as cancer immunotherapeutic
agent, after targeting the CD19 cell surface molecules expressed in various types of
cancers and are successfully transforming into clinic practice. Standing on the pillars of genetic
engineering, T cell biology, molecular biology, tumor biology, target identification, CAR-T therapy
holds great promise as off the shelf cancer therapeutic agent. Several unresolved concerns are
still prevailing. Various issues with regard to safety, efficacy and their preparation, quality control
issues, are still hampering our way. Cytokine release syndrome, neurological toxicities are few
major side effects of the therapy blocking the successful development of CAR-T cells in the clinical
Aim: Current review is dealing with structural aspects of CAR T cells, target and signalling, their
toxicity perspectives and current status and futuristic scope.
Method: By undertaking structured search approach, we had gone through various bibliographic
databases for peer-reviewed research literature on the focused research topic.
Results: The review identifies various issues with regard to safety, efficacy and their preparation,
structural aspects of CAR T cells, target and signalling, their toxicity perspectives and current
status and futuristic scope.
Conclusion: Amongst the most novel approaches, the CAR based research should be focussed on
effective tumor targeting with limited toxicity in normal tissues, to improve efficacy with modulation
of cell products or host cell products for rapid in vivo expansion.