CAR T therapy beyond cancer: the evolution of a living drug

Daniel J. Baker (), Zoltan Arany, Joseph A. Baur, Jonathan A. Epstein and Carl H. June ()
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Daniel J. Baker: Perelman School of Medicine at the University of Pennsylvania
Zoltan Arany: Perelman School of Medicine at the University of Pennsylvania
Joseph A. Baur: Perelman School of Medicine at the University of Pennsylvania
Jonathan A. Epstein: Perelman School of Medicine at the University of Pennsylvania
Carl H. June: Perelman School of Medicine at the University of Pennsylvania

Nature, 2023, vol. 619, issue 7971, 707-715

Abstract: Abstract Engineering a patient’s own T cells to selectively target and eliminate tumour cells has cured patients with untreatable haematologic cancers. These results have energized the field to apply chimaeric antigen receptor (CAR) T therapy throughout oncology. However, evidence from clinical and preclinical studies underscores the potential of CAR T therapy beyond oncology in treating autoimmunity, chronic infections, cardiac fibrosis, senescence-associated disease and other conditions. Concurrently, the deployment of new technologies and platforms provides further opportunity for the application of CAR T therapy to noncancerous pathologies. Here we review the rationale behind CAR T therapy, current challenges faced in oncology, a synopsis of preliminary reports in noncancerous diseases, and a discussion of relevant emerging technologies. We examine potential applications for this therapy in a wide range of contexts. Last, we highlight concerns regarding specificity and safety and outline the path forward for CAR T therapy beyond cancer.

Date: 2023
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DOI: 10.1038/s41586-023-06243-w

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