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4SCAR19 + 4SCAR38 is a **combination cell therapy** comprising two fourth-generation chimeric antigen receptor (CAR) T cell products: 4SCAR19 and 4SCAR38. Each product consists of autologous T cells engineered to express a CAR construct targeting specific surface antigens. 4SCAR19 targets CD19, a well-established B cell marker, and 4SCAR38 targets CD38, an antigen expressed on malignant plasma cells as well as other B cell malignancies. Both constructs incorporate multiple costimulatory domains (including CD28 and CD27) and an inducible safety switch (iCasp9) to enhance efficacy and allow controlled elimination of the cells in case of severe toxicity. The therapy is administered following lymphodepleting chemotherapy in patients with refractory or relapsed B-cell lymphoma or related malignancies. This approach aims to reduce the risk of antigen escape and relapse by targeting more than one antigen and overcoming resistance to single-antigen CAR-T treatment[3][5][9].
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