Explain the concept and process of chimeric antigen receptor development in immunotherapy

Question 1

What is chimeric antigen receptor

Answer 1

Genetically engineered receptor with tumour antigen-specific binding sites. Genetically engineered hybrids of AB and T cells. The antibody is able to bind to cancer cells

Question 2

Mechanism of CAR-T

Answer 2

Stimulate a T cell response against antigen-expressing cells, including normal and malignant cells. The external targeting domain binds to the antigen activating the CAR T cell

Question 3

Challenges

Answer 3

Toxicity associated with CAR T cell therapy observed are observed are Cytokine Release Syndrome (CRS) and Immune Effector Cell-associated Neurotoxicity Syndrome (ICANS)

Question 4

CRS

Answer 4

Induces inflammatory symptoms due to cytokine secretion as a result of immune activation of large numbers of lymphocytes. Due to higher levels of T-cell activation.
Managed by Ab blocking IL-6 receptors

Question 5

ICANS

Answer 5

Second most common serious adverse reaction after administration of CAR-T therapy. Patients develop toxic encephalopathy with confusion, seizures and cerebral oedema.
Reversed by anti-IL-6 therapy