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CD19 CAR-iNKT cells are engineered invariant natural killer T (iNKT) cells expressing a chimeric antigen receptor (CAR) targeting the CD19 antigen. This therapy combines the innate tissue-homing, immunoregulatory, and anti-tumor properties of iNKT cells with the targeted cytotoxicity provided by CD19 CAR specificity. In current clinical programs, these cells are further modified by insertion of an IL-15 transgene for enhanced persistence, and shRNAs against β2-microglobulin (β2M) and CD74 to reduce risk of host-versus-graft responses via downregulation of HLA class I and II. Primary clinical development is focused on allogeneic ("off-the-shelf") and autologous products for relapsed/refractory B-cell malignancies, including B-cell non-Hodgkin lymphoma and acute/chronic lymphocytic leukemia. Early-phase trials have shown favorable safety and preliminary efficacy, with dose-dependent cell expansion and tumor tissue infiltration, and minimal cytokine release syndrome. By targeting both CD19 (via the CAR) and, natively, CD1d, these cells exhibit dual cytotoxicity, potentially providing superior anti-tumor effects compared to conventional CAR-T cells[1][2][3][4].
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