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Anti-CD20-CD19 bispecific CAR T cells are an engineered cellular immunotherapy designed to treat B-cell malignancies by simultaneously targeting two clinically validated antigens, CD19 and CD20. The therapy utilizes a tandem chimeric antigen receptor (TanCAR) construct, which incorporates two distinct single-chain variable fragments (scFvs)—typically derived from the FMC63 (anti-CD19) and Leu16 or 2H7 (anti-CD20) clones—linked in a single extracellular domain. This design employs 'OR'-gate signaling logic, meaning the T cells achieve full activation and cytolytic function upon binding to either CD19 or CD20, or both. This dual-targeting strategy is specifically intended to overcome the limitations of monospecific CAR-T therapies, such as relapse caused by antigen-loss variants (e.g., CD19-negative escape) and the inherent heterogeneity of antigen expression in diseases like pediatric acute lymphoblastic leukemia (ALL) and chronic lymphocytic leukemia (CLL).
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