CAR-T THERAPY: MECHANISMS OF ACTION, CLINICAL APPLICATIONS AND FUTURE DIRECTIONS

Mateusz Winkler; Julia Bezak; Aleksandra  Arczewska; Michał Zaborowski; Klaudia Purgał-Zaborowska; Klaudia Michałowska; Oliwier Kolanowski; Olga Turzańska; Szymon Marciszuk

doi:10.31435/ijitss.2(50).2026.5693

Authors

Mateusz Winkler Nikolaus Copernicus University in Torun, Collegium Medicum, Bydgoszcz, Poland https://orcid.org/0009-0004-4518-4728
Julia Bezak Medical University of Lodz, Lodz, Poland https://orcid.org/0009-0005-8598-5594
Aleksandra Arczewska Medical University of Lodz, Lodz, Poland https://orcid.org/0009-0008-3092-7364
Michał Zaborowski Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0009-0002-7598-3737
Klaudia Purgał-Zaborowska Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0009-0007-2411-1601
Klaudia Michałowska Nikolaus Copernicus University in Torun, Collegium Medicum, Bydgoszcz, Poland https://orcid.org/0009-0003-7782-2264
Oliwier Kolanowski Nikolaus Copernicus University in Torun, Collegium Medicum, Bydgoszcz, Poland https://orcid.org/0009-0005-0278-1941
Olga Turzańska Jagiellonian University in Krakow, Krakow, Poland https://orcid.org/0009-0007-9495-5834
Szymon Marciszuk Medical University of Lodz, Lodz, Poland https://orcid.org/0009-0003-9917-0762

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5693

Keywords:

CAR-T Cells, Immunotherapy, Hematologic Malignancies, Solid Tumors, Cytokine Release Syndrome, Cancer Therapy

Abstract

Chimeric antigen receptor T-cell (CAR-T) therapy represents a major advancement in cancer immunotherapy, introducing a novel therapeutic approach based on the genetic modification of T lymphocytes to enhance tumor-specific cytotoxicity. This strategy has significantly transformed the treatment landscape, particularly in hematologic malignancies. The aim of this review is to summarize the current state of knowledge regarding CAR-T therapy, including its mechanisms of action, clinical applications, toxicity profile, limitations, and future directions of development. A narrative review of the literature was conducted based on selected publications indexed in biomedical databases, with particular emphasis on recent advances in both hematologic and solid tumors. CAR-T therapy has demonstrated high clinical efficacy in hematologic malignancies, especially B-cell cancers such as acute lymphoblastic leukemia and multiple myeloma, achieving substantial response rates in patients with relapsed or refractory disease. In contrast, its application in solid tumors remains limited due to challenges including antigen heterogeneity, an immunosuppressive tumor microenvironment, and reduced T-cell infiltration. The therapy is associated with characteristic toxicities, most notably cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, which require careful monitoring and management. Furthermore, its broader implementation is constrained by complex manufacturing processes, high costs, and limited accessibility. Ongoing research focuses on improving CAR-T cell persistence, overcoming T-cell exhaustion, optimizing antigen targeting, and developing novel strategies such as allogeneic products and combination therapies. In conclusion, CAR-T therapy constitutes a transformative modality in modern oncology, with established efficacy in hematologic malignancies and emerging potential in solid tumors, and its continued development is expected to further expand its clinical utility.

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