Emerging Strategies to Overcome Current CAR-T Therapy Dilemmas - Exosomes Derived from CAR-T Cells

Adoptive T cells immunotherapy, specifically chimeric antigen receptor T cells (CAR -T), has shown promising therapeutic efficacy in the treatment of hematologic malignancies. As extensive research on CAR -T therapies has been conducted, various challenges have emerged that significantly hampered their clinical application, including tumor recurrence, CAR -T cell exhaustion, and cytokine release syndrome (CRS). To overcome the hurdles of CAR -T therapy in clinical treatment, cell -free emerging therapies based on exosomes derived from CAR -T cells have been developed as an effective and promising alternative approach. In this review, we present CAR -T cell -based therapies for the treatment of tumors, including the features and benefits of CAR -T therapies, the limitations that exist in this field, and the measures taken to overcome them. Furthermore, we discuss the notable benefits of utilizing exosomes released from CAR -T cells in tumor treatment and anticipate potential issues in clinical trials. Lastly, drawing from previous research on exosomes from CAR -T cells and the characteristics of exosomes, we propose strategies to overcome these restrictions. Additionally, the review discusses the plight in large-scale preparation of exosome and provides potential solutions for future clinical applications.