CAR T-cell Therapy Toxicities and Management

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What is the main difference in T cell activation between CD28 and 4-1BB in CD19 CAR T cells?

CD28 induces rapid T cell activation, whereas 4-1BB induces slower T cell activation.

How do the metabolic pathways differ between CD28 and 4-1BB CAR T cells?

CD28 CAR T cells undergo aerobic glycolysis, whereas 4-1BB CAR T cells undergo oxidative metabolism.

What is the duration of persistence for 4-1BB CAR T cells compared to CD28 CAR T cells?

4-1BB CAR T cells persist for up to 5 years, whereas CD28 CAR T cells persist for approximately 3 months.

What is the function of the extracellular binding domain in a CAR?

The extracellular binding domain recognizes and binds to a specific target antigen on tumor cells.

What is the purpose of the hinge domain in a CAR?

The hinge domain provides flexibility and spacer function between the extracellular binding domain and the transmembrane domain.

What are the advantages of using CD19 as a target antigen in CAR T cell therapy?

CD19 is a specific antigen expressed on B cells, allowing for targeted therapy with minimal off-tumor effects.

What is the role of the intracellular domain in a CAR?

The intracellular domain transduces signals to activate T cells and induce effector functions.

What are the advantages of using 4-1BB as a co-stimulatory molecule in CAR T cells?

4-1BB promotes slower T cell activation, leading to prolonged persistence and reduced toxicity.

How does the structure of a CAR impact its function?

The structure of a CAR, including the extracellular binding domain, hinge domain, transmembrane domain, and intracellular domain, determines its ability to target and activate T cells.

What are the implications of using different target antigens in CAR T cell therapy?

Different target antigens can impact the specificity and efficacy of CAR T cell therapy, as well as the risk of off-tumor effects.

What are the advantages of using CAR T cells compared to TILs and TCR-based strategies?

CAR T cells can be rapidly expanded and modified, and can target specific tumor antigens, allowing for more targeted therapy.

This quiz covers the toxicities related to CAR T-cell therapy, including cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, and on-target off-tumor toxicity. It also explores strategies to reduce side effects and antigen-escape after CAR T-cell therapy.

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