AUTHOR=Cheng Jiali , Zhao Lei , Zhang Yuanyuan , Qin Yun , Guan Yuqi , Zhang Tong , Liu Chaohong , Zhou Jianfeng TITLE=Understanding the Mechanisms of Resistance to CAR T-Cell Therapy in Malignancies JOURNAL=Frontiers in Oncology VOLUME=9 YEAR=2019 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2019.01237 DOI=10.3389/fonc.2019.01237 ISSN=2234-943X ABSTRACT=

Taking advantage of the immune system to exert an antitumor effect is currently a novel approach in cancer therapy. Adoptive transfer of T cells engineered to express chimeric antigen receptors (CARs) targeting a desired antigen has shown extraordinary antitumor activity, especially in refractory and relapsed B-cell malignancies. The most representative in this respect, as well as the most successful example, is CD19 CAR T-cell therapy in B-cell acute lymphoblastic leukemia (B-ALL). However, with the widespread use of CAR T-cell therapy, problems of resistance and relapse are starting to be considered. This review provides a comprehensive picture of the mechanisms of resistance to CAR T-cell therapy from three aspects, namely, CAR T-cell factors, tumor factors, and tumor microenvironment factors, offering insights for improving CAR T-cell therapy.