Reprogramming CAR-T Cell Therapy for Solid Tumors: Combination Strategies to Overcome Resistance

Engineering CAR-T cells for solid tumors: overcoming antigenic, trafficking, and microenvironmental barriers

Next-generation engineering strategies are being designed to overcome the obstacles that constrain CAR-T-cell efficacy in solid tumors and to guide the development of safer and more effective therapeutic platforms.

T cell-based immunotherapy in solid tumors: mechanistic barriers and emerging opportunities.

CAR-T Cell Therapy for Glioblastoma: Obstacles and Advances.

Glioblastoma (GBM) is the most aggressive primary malignancy of the central nervous system. Chimeric antigen receptor T (CAR-T) cell therapy has shown promising therapeutic potential against GBM, yet its efficacy remains constrained by multiple barriers, including physical barriers imposed by the blood-brain barrier and extracellular matrix, the immunosuppressive tumor microenvironment, spatiotemporal antigen heterogeneity, and safety concerns. In this review, we summarize the major obstacles limiting CAR-T therapy in GBM and discuss emerging strategies to overcome these challenges. Next-generation engineered CAR-T cells-through armored modifications, logic-gated regulation, and dual-targeting approaches-enhance specificity, persistence, and controllability. Concurrently, combinatorial approaches leveraging biomaterials enable localized delivery and sustained release of CAR-T cells, while physical modalities, such as focused ultrasound and thermal modulation, can transiently disrupt the blood-brain barrier or induce immunogenic cell death. Integration with real-time imaging further enables dynamic monitoring of therapeutic responses. Together, these synergistic strategies may enhance antitumor efficacy while minimizing systemic toxicity, paving the way for future CAR-T-based therapies in glioblastoma.

Integrated Engineering of CAR‐T Cells for Solid Tumours

ABSTRACT Chimeric antigen receptor (CAR) T‐cell therapy has achieved durable efficacy in hematologic malignancies but encounters persistent obstacles in solid tumours, including antigen heterogeneity, a suppressive tumour microenvironment (TME), and intrinsic T‐cell dysfunction. This review examines the transition from single‐axis engineering to an integrated framework that addresses these hurdles in sequence. We delineate how next‐generation CAR‐T cells are designed for precise spatiotemporal activation through logic‐gated and pharmacologically regulatable receptors, while being reinforced by metabolic and epigenetic reprogramming to resist TME‐driven exhaustion. We also assess strategies that actively reshape the immunosuppressive TME, including depletion of regulatory cell populations, blockade of ‘don't eat me’ signals, and the use of biomaterial scaffolds for locoregional delivery. The synthesis of controllable activation, intrinsic resilience, and extrinsic TME modulation is defining a class of adaptive therapeutic systems. Clinical implementation of this approach requires careful management of toxicities, notably cytokine release syndrome (CRS), and support from advanced monitoring technologies. Progress will depend on rational combinations that move beyond isolated optimisations, enabling cellular therapies to dynamically respond to evolving tumour ecosystems and narrowing the efficacy gap between hematologic and solid cancers.

Emerging CAR-T Cell Therapies for T Cell Malignancies: Innovations, Challenges, and Future Directions

Continued efforts to identify highly specific target antigens, optimize manufacturing processes, enhance safety, and integrate CAR-T therapy with complementary immunotherapeutic approaches are expected to improve clinical outcomes and broaden the application of CAR-T therapy to T-cell malignancies and potentially other solid and hematologic cancers.

Transient T cell therapies.