International Journal of Nanomedicine (Mar 2024)

Emerging Strategies to Overcome Current CAR-T Therapy Dilemmas - Exosomes Derived from CAR-T Cells

  • Hu D,
  • Yang R,
  • Wang G,
  • Li H,
  • Fan X,
  • Liang G

Journal volume & issue
Vol. Volume 19
pp. 2773 – 2791

Abstract

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Dong Hu,1 Ruyue Yang,1 Guidan Wang,2 Hao Li,1 Xulong Fan,1 Gaofeng Liang1 1School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, People’s Republic of China; 2School of Medical Technology and Engineering, Henan University of Science & Technology, Luoyang, 471023, People’s Republic of ChinaCorrespondence: Gaofeng Liang, School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, People’s Republic of China, Email [email protected]: Adoptive T cells immunotherapy, specifically chimeric antigen receptor T cells (CAR-T), has shown promising therapeutic efficacy in the treatment of hematologic malignancies. As extensive research on CAR-T therapies has been conducted, various challenges have emerged that significantly hampered their clinical application, including tumor recurrence, CAR-T cell exhaustion, and cytokine release syndrome (CRS). To overcome the hurdles of CAR-T therapy in clinical treatment, cell-free emerging therapies based on exosomes derived from CAR-T cells have been developed as an effective and promising alternative approach. In this review, we present CAR-T cell-based therapies for the treatment of tumors, including the features and benefits of CAR-T therapies, the limitations that exist in this field, and the measures taken to overcome them. Furthermore, we discuss the notable benefits of utilizing exosomes released from CAR-T cells in tumor treatment and anticipate potential issues in clinical trials. Lastly, drawing from previous research on exosomes from CAR-T cells and the characteristics of exosomes, we propose strategies to overcome these restrictions. Additionally, the review discusses the plight in large-scale preparation of exosome and provides potential solutions for future clinical applications.Keywords: tumor, CAR-T cells, immune escape, exosome

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