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Multiantigen targeted CAR T-cell therapy
Source: Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 21, 2025 · Captured 2026-09-09.
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Investigators have tested approaches aimed at targeting multiple ALL antigens to overcome relapse caused by immune escape. Studies have included the following approaches:
Use of two independently manufactured CAR T cells targeted at different antigens infused simultaneously or sequentially.
A single manufacturing process of CAR T cells that contain two populations of cells, each targeted at a different antigen.
A single manufacturing process where one CAR construct has binding domains to multiple antigens.
While none of these approaches are commercially available, studies of this approach are ongoing.
A large study included Chinese patients who received a 1:1 mix of independently manufactured CD19- and CD22-targeted CAR T cells. This treatment produced remission in 99% of patients. Persistent B-cell aplasia at 6 months and HSCT after CAR T cells were each associated with improved survival.[208]
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A second study in China infused CD19-targeted CAR T cells followed by CD22-targeted T cells after achieving remission. This resulted in an 18-month EFS rate of 80%, with HSCT occurring in only 10% of patients.[209]
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Three additional trials examined single manufacturing processes of multitargeted CAR T cells. Treatment with this type of CAR T cells resulted in reasonable rates of remission. However, the duration of CAR T cells was poor, and patient outcomes were no better with this CAR T-cell therapy than outcomes with commercial CD19-targeted CAR T cells.[210-212]
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