CAR T-cell therapies
The patient's own T cells, genetically engineered to recognise a tumour antigen such as CD19 or BCMA and given back as a single infusion.
What they are
Chimeric antigen receptor (CAR) T cells are a living drug. T cells are collected by leukapheresis, given a gene for a synthetic receptor, expanded and returned after lymphodepleting chemotherapy. Most approved products target CD19 (B-cell leukaemias and lymphomas); others target BCMA (multiple myeloma). The «-cel» names read «gen» (genetic modification), «leu» (leukocytes) and «cel» (cells).
Mechanism of action
The CAR joins an antibody fragment (scFv) that recognises the antigen to the T-cell signalling chain CD3ζ and a costimulatory domain (4-1BB or CD28). Binding to the antigen activates the T cell without needing MHC presentation; it kills the target cell, multiplies and can persist. The massive activation releases cytokines such as IL-6.
Target: Tumour surface antigens (CD19 on B cells, BCMA on plasma cells)
Drugs in this class
- TisagenlecleucelThe first CD19 CAR T-cell therapy: the patient's own T cells, engineered to kill B-cell leukaemia and lymphoma. Main…CD19 on normal and malignant B cells
- Axicabtagene ciloleucelAnti-CD19 CAR T-cell therapy for large B-cell and follicular lymphoma, given as one infusion. Boxed risks: cytokine…CD19 on normal and malignant B cells
Others in the class
- lisocabtagene maraleucel
- brexucabtagene autoleucel
- idecabtagene vicleucel
- ciltacabtagene autoleucel
- obecabtagene autoleucel
Test yourself
Think of the answer, then tap the question to see it.
What are the two main parts of a chimeric antigen receptor?
An antibody fragment (scFv) outside the cell that recognises the antigen and T-cell signalling domains (CD3ζ plus a costimulatory domain) inside.
Which drug blocks IL-6 signalling in severe cytokine release syndrome?
Tocilizumab, an antibody against the IL-6 receptor.
Why does a CAR T cell not need MHC to recognise its target?
Because its receptor is antibody-based and binds the surface antigen directly.
What does ICANS stand for?
Immune effector cell-associated neurotoxicity syndrome.
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Tisagenlecleucel Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Axicabtagene Ciloleucel Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.