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14g2a.zeta transduced autologous peripheral blood T-cells is an experimental chimeric antigen receptor (CAR) T-cell therapy developed by Baylor College of Medicine for the treatment of high-risk neuroblastoma. The therapy involves the genetic modification of a patient's own peripheral blood T-cells to express a CAR that targets the disialoganglioside GD2, a tumor-associated antigen highly expressed on neuroblastoma cells. The CAR construct utilizes the 14g2a single-chain variable fragment (scFv), derived from an anti-GD2 monoclonal antibody, for antigen recognition and the CD3-zeta signaling domain for T-cell activation. In clinical studies such as the NESTLES trial, these cells are often co-administered with GD2-targeted Epstein-Barr virus (EBV)-specific cytotoxic T lymphocytes (CTLs) to improve the persistence and anti-tumor activity of the treatment. Challenges observed in early trials include limited efficacy and T-cell exhaustion, potentially linked to tonic signaling caused by CAR aggregation on the cell surface.
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