Car-T Cell Therapy: A Paradigm Shift in Cancer Treatment

Chimeric antigen receptor T-cell (CAR-T) therapy, a major application of precision and customized medicine, has emerged as a revolutionary advancement in cancer immunotherapy. CAR-T therapy genetically alters a patient's T cells to express synthetic receptors that accurately identify tumor-associated antigens in an MHC-independent manner, resulting in potent and targeted anticancer activity. This study provides an overview of the fundamental ideas of CAR-T cell therapy, including T-cell biology, CAR structure and generations, and the production process, which includes leukapheresis, genetic engineering, ex vivo expansion, conditioning chemotherapy, and patient injection. The mechanisms underlying CAR-T-mediated tumor destruction include antigen recognition, T-cell activation, cytotoxic effector pathways, cytokine production, and tumor lysis. We examine the most recent FDA-approved CAR-T treatments and their clinical applications. We also discuss novel applications in solid tumors and associated issues, such as immune-suppressive tumor microenvironment and antigen heterogeneity. The primary adverse effects, such as immune effector cell-associated neurotoxicity syndrome and cytokine release syndrome, are also discussed in the review along with current treatments. Finally, the drawbacks of CAR-T therapy, recent advances in technology, and the evolving CAR-T environment in India including domestic innovations are examined.