CAR T-Cell Therapies with a Bispecific Twist: To Bypass Antigen Escape, TanCAR and NanoCAR Therapies Take the Bispecific Route

chimeric antigen receptor (CAR) T-cell therapy has matured rapidly. What used to be the “drug of the future” is suddenly the “drug of the now.” The first CAR T-cell therapeutic, Kymriah, was approved by the FDA about 10 months ago, and there are at least 300 different CAR T-cell-based clinical trials being conducted across the globe. Even more numerous are the CAR T-cell projects currently in the discovery or preclinical phases of development. In these projects, multitudes of cancer types, targets, and formats are being evaluated. All this activity makes for a robust CAR T-cell market. Currently worth an estimated $168.7 million, the CAR T-cell market is expected to maintain a compound annual growth rate of 46.2% from 2019 to 2028. These enviable figures are partly due to Kymriah’s demonstrated efficacy in treating acute lymphoblastic leukemia. Kymriah targets CD19, the most prevalent marker of B-cell malignancies, and shows a high overall response rate. After treatment commences, about 83% of patients experience remission within three months. In up to half of all treated patients, however, remission is only temporary because antigen escape occurs, allowing cancer to recur.