Clinical Strategies for Enhancing the Efficacy of CAR T-Cell Therapy for Hematological Malignancies

SIMPLE SUMMARY: Cellular immunotherapy has achieved great progress in the treatment of hematological malignancies, and cell therapy may become the main force in the treatment of refractory and relapsed malignant tumors in the future. The efficacy of CAR T cells as a potential cell therapy in the treatment of hematological tumors is acknowledged. Given that clinical application strategies for optimizing CAR T-cell therapy are still immature, this article reviews the impact of various application strategies on CAR T-cell therapy. ABSTRACT: Chimeric antigen receptor (CAR) T cells have been successfully used for hematological malignancies, especially for relapsed/refractory B-cell acute lymphoblastic leukemia and non-Hodgkin’s lymphoma. Patients who have undergone conventional chemo-immunotherapy and have relapsed can achieve complete remission for several months with the infusion of CAR T-cells. However, side effects and short duration of response are still major barriers to further CAR T-cell therapy. To improve the efficacy, multiple targets, the discovery of new target antigens, and CAR T-cell optimization have been extensively studied. Nevertheless, the fact that the determination of the efficacy of CAR T-cell therapy is inseparable from the discussion of clinical application strategies has rarely been discussed. In this review, we will discuss some clinical application strategies, including lymphodepletion regimens, dosing strategies, combination treatment, and side effect management, which are closely related to augmenting and maximizing the efficacy of CAR T-cell therapy.