CAR T Cell Therapy as Living Drugs in Cancer: A Comprehensive Pharmacological and Clinical Overview

In the fight against cancer, cellular immunotherapy has emerged as a powerful tool in recent years. Chimeric antigen receptors (CARs), which are synthetic receptors comprising four components, have shown remarkable adaptability and efficacy in treating cancer. Specifically, CAR-T cell therapy involves modifying a patient's T cells to express synthetic receptors targeted towards tumor antigens. Unlike traditional drug-based cancer therapies which broadly target cancer cells, CAR-T cell therapy aims to selectively target tumors while avoiding healthy tissues. Current CAR-T cell therapies are targeted toward various antigens, with CD19 and BCMA being primarily used for hematological malignancies. Combining CAR-T cells with other drugs, such as antibodies or small molecules, has shown promising results in enhancing their efficacy.

Additionally, chemotherapy can augment CAR-T cell therapy by boosting the immune system while simultaneously reducing tumor load. The pharmacodynamics and pharmacokinetics of CAR-T cells, which function as "living drugs", are complex and require detailed consideration of the type and length of interactions between CAR-T cells and target cells. This article aims to explore the pharmacology of CAR-T cells and pinpoint significant knowledge gaps in this rapidly developing field.