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CAR4-DNT is an off-the-shelf, allogeneic chimeric antigen receptor (CAR) T-cell therapy consisting of CD3+CD4-CD8- double-negative T cells (DNTs) engineered to express a CD4-targeted CAR. Developed by researchers at the University Health Network, the University of Toronto, and the University of Calgary, CAR4-DNT leverages the unique properties of DNTs, which naturally lack CD4 expression (preventing fratricide during manufacturing) and possess endogenous anti-leukemic activity. Preclinical studies have demonstrated that CAR4-DNT effectively targets and eliminates CD4-expressing malignant cells in acute myeloid leukemia (AML), T-cell acute lymphoblastic leukemia (T-ALL), and peripheral T-cell lymphoma (PTCL) without causing fratricide or graft-versus-host disease (GvHD). Pretreatment with the PI3Kδ inhibitor idelalisib has been shown to promote a memory phenotype and enhance the persistence and efficacy of CAR4-DNTs in vivo.
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