Strengthening the CAR-T Cell Therapeutic Application using CRISPR/Cas9
Technology
Abstract
Adoptive cell immunotherapy with chimeric antigen receptor (CAR) T cell
has brought a revolutionary means of treatment for aggressive diseases
such as hematologic malignancies and solid tumors. Over the last decade,
FDA approved three types of CAR-T cells against CD19 hematologic
malignancies, including Tisagenlecleucel (Kymriah), Axicabtagene
ciloleucel (Yescarta), and Brexucabtagene autoleucel (Tecartus). Despite
outstanding results gained from different clinical trials, CAR-T cell
therapy is not free from side effects and toxicities, and needs careful
investigations and improvements. Gene-editing technology, clustered
regularly interspaced short palindromic repeats (CRISPR)/
CRISPR-associated protein 9 (Cas9) system has emerged as a promising
tool to address some of the CAR-T therapy hurdles. Using CRISPR/Cas9
technology, CAR expression as well as other cellular pathways can be
modified in various ways to enhance CAR-T cell’s anti-tumor function and
persistence in immunosuppressive tumor microenvironment. CRISPR/Cas9
technology can also be utilized to reduce CAR-T cells toxicity and side
effects. Hereby, we discuss the practical challenges and hurdles related
to the accuracy, efficiency, efficacy, safety and delivery of
CRISPR/Cas9 technology to the genetically engineered-T cells. Combining
of these two state-of-the-art technologies, CRISPR/Cas9 and CAR-T cells,
the field of oncology has an extraordinary opportunity to enter a new
era of immunotherapy, which offers novel therapeutic options for
different types of tumors.