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28z CAR-T is a second-generation chimeric antigen receptor (CAR) T-cell therapy targeting the CD19 antigen, engineered with a CD28 co-stimulatory domain and a CD3ζ intracellular signaling domain. Developed by Immunochina Pharmaceuticals, the construct utilizes an FMC63-derived single-chain variable fragment (scFv) for B-cell recognition. In clinical evaluations for relapsed or refractory B-cell non-Hodgkin’s lymphoma (B-NHL), 28z CAR-T demonstrated significant antitumor activity but was associated with a high incidence of severe adverse events, including grade 3 or higher cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Due to these safety concerns, further clinical development of this specific 28z construct was terminated in favor of 4-1BB-based alternatives (BBz CAR-T), which exhibited a more manageable safety profile.
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