Cellular immunotherapy, particularly CAR-T cells, has shown potential in the improvement of outcomes in patients with refractory and recurrent malignancies of the blood. However, achieving sustainable long-term complete remission for blood cancer remains a challenge, with resistance and relapse being expected outcomes for many patients. Although many studies have attempted to clarify the mechanisms of CAR-T cell therapy failure, the mechanism remains unclear. In this article, we discuss and describe the current state of knowledge regarding these factors, which include elements that influence the CAR-T cell, cancer cells as a whole, and the microenvironment surrounding the tumor. In addition, we propose prospective approaches to overcome these obstacles in an effort to decrease recurrence rates and extend patient survival subsequent to CAR-T cell therapy.

中文翻译：

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血液恶性肿瘤中 CAR-T 细胞疗法的挑战和策略

细胞免疫疗法，特别是 CAR-T 细胞，已显示出改善难治性和复发性血液恶性肿瘤患者预后的潜力。然而，实现血癌可持续的长期完全缓解仍然是一个挑战，许多患者预计会出现耐药和复发。尽管许多研究试图阐明CAR-T细胞治疗失败的机制，但其机制仍不清楚。在本文中，我们讨论并描述了有关这些因素的当前知识状况，其中包括影响 CAR-T 细胞、整个癌细胞以及肿瘤周围微环境的因素。此外，我们提出了克服这些障碍的前瞻性方法，以努力降低复发率并延长 CAR-T 细胞治疗后患者的生存期。