Advances in CAR-T Cell Therapy: Personalized Immunotherapy and the Future of Precision Cancer Treatment
DOI:
https://doi.org/10.64784/233Palabras clave:
CAR-T therapy, chimeric antigen receptor, cancer immunotherapy, personalized medicine, precision oncology, hematological malignancies, cellular therapy, gene engineering, adoptive immunotherapy, leukemia, lymphoma, multiple myeloma, solid tumors, biotechnology, translational medicine, Latin America.Resumen
Chimeric antigen receptor T-cell (CAR-T) therapy has emerged as one of the most significant advances in contemporary oncology, representing a transformative approach within the field of personalized cancer immunotherapy. By genetically engineering T lymphocytes to recognize and eliminate malignant cells through specific antigen-targeting mechanisms, CAR-T therapy has demonstrated remarkable clinical efficacy in several hematological malignancies, including acute lymphoblastic leukemia, diffuse large B-cell lymphoma, mantle cell lymphoma, and multiple myeloma. This review analyzes the biological foundations, clinical applications, therapeutic outcomes, safety considerations, and future perspectives associated with CAR-T technology. The available evidence indicates that CAR-T therapy has achieved unprecedented response rates in patients with relapsed or refractory disease, significantly improving treatment possibilities for populations with historically poor prognoses. However, important challenges remain regarding treatment-related toxicities, manufacturing complexity, economic sustainability, accessibility, and limited effectiveness in solid tumors. Recent advances in genetic engineering, synthetic biology, biomarker discovery, and precision medicine are driving the development of next-generation CAR-T platforms designed to enhance efficacy, safety, and applicability across a broader spectrum of cancers. Furthermore, growing interest in Latin America, particularly in Mexico, Colombia, and Ecuador, reflects increasing efforts to expand access to advanced cellular therapies through academic collaboration, translational research, and healthcare innovation. The findings suggest that CAR-T therapy will continue to play a central role in the evolution of precision oncology and may serve as a model for future individualized therapeutic strategies in cancer management.
Referencias
• Berdeja, J. G., Madduri, D., Usmani, S. Z., Jakubowiak, A., Agha, M., Cohen, A. D., … Jagannath, S. (2021). Ciltacabtagene autoleucel, a B-cell maturation antigen-directed CAR-T cell therapy in patients with relapsed or refractory multiple myeloma. The Lancet, 398(10297), 314–324.
• Brudno, J. N., & Kochenderfer, J. N. (2024). CAR T cells and T-cell therapies for cancer. JAMA, 332(18), 1529–1540.
• Bustamante-Ogando, J. C., et al. (2024). Towards implementing CAR-T cell therapy programs for childhood leukemia in Mexico. Frontiers in Oncology, 14, 1–10.
• Feins, S., Kong, W., Williams, E. F., Milone, M. C., & Fraietta, J. A. (2019). An introduction to chimeric antigen receptor (CAR) T-cell immunotherapy for human cancer. American Journal of Hematology, 94(S1), S3–S9.
• Frey, N., & Porter, D. (2019). Cytokine release syndrome with chimeric antigen receptor T cell therapy. Biology of Blood and Marrow Transplantation, 25(4), e123–e127.
• June, C. H., O'Connor, R. S., Kawalekar, O. U., Ghassemi, S., & Milone, M. C. (2018). CAR T cell immunotherapy for human cancer. Science, 359(6382), 1361–1365.
• Lee, D. W., Santomasso, B. D., Locke, F. L., Ghobadi, A., Turtle, C. J., Brudno, J. N., … Neelapu, S. S. (2019). ASTCT consensus grading for cytokine release syndrome and neurologic toxicity associated with immune effector cells. Biology of Blood and Marrow Transplantation, 25(4), 625–638.
• Maude, S. L., Laetsch, T. W., Buechner, J., Rives, S., Boyer, M., Bittencourt, H., … Grupp, S. A. (2018). Tisagenlecleucel in children and young adults with B-cell lymphoblastic leukemia. The New England Journal of Medicine, 378(5), 439–448.
• Munshi, N. C., Anderson, L. D., Shah, N., Madduri, D., Berdeja, J., Lonial, S., … Raje, N. (2021). Idecabtagene vicleucel in relapsed and refractory multiple myeloma. The New England Journal of Medicine, 384(8), 705–716.
• Neelapu, S. S., Locke, F. L., Bartlett, N. L., Lekakis, L. J., Miklos, D. B., Jacobson, C. A., … Go, W. Y. (2017). Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma. The New England Journal of Medicine, 377(26), 2531–2544.
• Olejarz, W., Kubiak-Tomaszewska, G., & Czarnecka, A. M. (2024). Advancements in personalized CAR-T therapy. International Journal of Molecular Sciences, 25(14), 1–21.
• Peng, L., Shang, Y., Li, X., & Zhao, Y. (2024). CAR-T and CAR-NK as cellular cancer immunotherapy for solid tumors. Cellular & Molecular Immunology, 21, 1–20.
• Raje, N., Berdeja, J., Lin, Y., Siegel, D., Jagannath, S., Madduri, D., … Kochenderfer, J. N. (2019). Anti-BCMA CAR T-cell therapy bb2121 in relapsed or refractory multiple myeloma. The New England Journal of Medicine, 380(18), 1726–1737.
• Robledo, J. E. G., et al. (2025). The impact of CAR T-cell therapy on current cancer management and its outlook in Colombia. Revista Colombiana de Cancerología, 29, 1–10.
• Schuster, S. J., Bishop, M. R., Tam, C. S., Waller, E. K., Borchmann, P., McGuirk, J. P., … Maziarz, R. T. (2019). Tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma. The New England Journal of Medicine, 380(1), 45–56.
• Sun, D., Shi, X., Li, S., Wang, X., & Hu, Y. (2024). CAR-T cell therapy: A breakthrough in traditional cancer treatment strategies. Molecular Medicine Reports, 29(2), 1–15.
• Toro-Pedroza, A., et al. (2026). Advancing CAR-T cell manufacturing in Latin America. Cytotherapy. Advance online publication.
• Wagner, D. L., Fritsche, E., Pulsipher, M. A., Ahmed, N., Hamieh, M., Hegde, M., … Ruella, M. (2021). Immunogenicity of CAR T cells in cancer therapy. Nature Reviews Clinical Oncology, 18(6), 379–393.
• Wang, C., Chen, S., & Chen, J. (2023). CAR-T cell therapy for hematological malignancies: Current opportunities and challenges. Frontiers in Immunology, 14, 1–15.
• Wang, M., Munoz, J., Goy, A., Locke, F. L., Jacobson, C. A., Hill, B. T., … KTE-X19 Investigators. (2020). KTE-X19 CAR T-cell therapy in relapsed or refractory mantle-cell lymphoma. The New England Journal of Medicine, 382(14), 1331–1342.
