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Anaplastic lymphoma kinase (ALK)-directed chimeric antigen receptor (CAR) T-cell therapy is an investigational cellular immunotherapy designed to target ALK-expressing malignancies, particularly high-risk neuroblastoma and fusion-positive rhabdomyosarcoma. Developed by researchers at the Children's Hospital of Philadelphia, these CAR T cells utilize high-affinity single-chain variable fragments (scFvs) to recognize the extracellular domain of the ALK oncofetal protein. Optimized architectures often incorporate CD28 transmembrane and costimulatory domains to enhance antigen sensitivity and functional persistence against tumors with varying ALK density. Next-generation iterations of this platform include modifications such as FOXO1 overexpression and NFAT-inducible IL-15 expression to overcome the immunosuppressive solid tumor microenvironment and prevent T-cell exhaustion.
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