Therapeutic T cell engineering

Genetically engineered T cells are powerful new medicines, offering hope for curative responses in patients with cancer. Chimaeric antigen receptors (CARs) are a class of synthetic receptors that reprogram lymphocyte specificity and function. CARs targeting CD19 have demonstrated remarkable potency in B cell malignancies. Engineered T cells are applicable in principle to many cancers, pending further progress to identify suitable target antigens, overcome immunosuppressive tumour microenvironments, reduce toxicities, and prevent antigen escape. Advances in the selection of optimal T cells, genetic engineering, and cell manufacturing are poised to broaden T-cell-based therapies and foster new applications in infectious diseases and autoimmunity. The use of genetically engineered T cells in the treatment of cancer is reviewed, with particular focus on anti-CD19 chimaeric antigen receptor therapy, providing a summary of past progress and current status, and potential future directions. Michel Sadelain and colleagues review the use of genetically engineered T cells in the treatment of patients with cancer. They focus in particular on anti-CD19 chimaeric antigen receptor (CAR)-modified T cell therapy for leukaemia and lymphoma, providing a summary of past progress and current status, and discuss potential future directions encompassing solid tumours.