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CART-meso cells are autologous T lymphocytes genetically engineered to express a chimeric antigen receptor (CAR) that specifically targets mesothelin, a cell surface protein highly expressed in several solid tumors such as malignant pleural mesothelioma, ovarian carcinoma, and pancreatic ductal adenocarcinoma. The CAR construct typically includes an anti-mesothelin single-chain variable fragment (scFv), fused to intracellular signaling domains such as CD3ζ and 4-1BB (CD137), enabling the modified T cells to recognize and kill mesothelin-expressing tumor cells. These therapies are developed as personalized immunotherapies where a patient's own T cells are collected via apheresis, modified ex vivo with viral vectors or mRNA transfection to express the anti-mesothelin CAR, expanded in culture, and then reinfused into the patient. Clinical trials have demonstrated feasibility and safety of both mRNA- and lentiviral-transduced CART-meso cell products in patients with advanced cancers; observed clinical activity has been limited but includes evidence of tumor targeting and immune activation[5][6][7][8][10].
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