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4SCAR-FRa is an autologous, fourth-generation chimeric antigen receptor (CAR) T-cell therapy designed to target solid tumors expressing Folate Receptor alpha (FRa), also known as FOLR1. Developed by the Shenzhen Geno-Immune Medical Institute, the therapy utilizes T cells genetically modified with a lentiviral vector to express a CAR construct. This construct includes an anti-FRa single-chain variable fragment (scFv) linked to a tandem signaling domain comprising the costimulatory molecules CD28, CD137 (4-1BB), and CD27, along with the CD3 zeta chain for primary T-cell activation. A distinctive feature of the 4SCAR platform is the inclusion of an inducible caspase 9 (iCasp9) safety switch, which allows for the selective elimination of the CAR-T cells through the administration of a chemical homodimerizer (such as AP1903/rimiducid) in the event of severe adverse effects like cytokine release syndrome. The agent is primarily being investigated for the treatment of FRa-positive malignancies, including bladder cancer (urothelial carcinoma) and ovarian cancer.
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