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CD19-CD133 bispecific CAR-iNKT is a preclinical, allogeneic, off-the-shelf cell therapy utilizing invariant natural killer T (iNKT) cells. These cells are engineered to co-express two chimeric antigen receptors (CARs): a second-generation CD19-28ζ CAR and a CD133-4-1BBζ CAR. This dual-targeting approach is designed to enhance antileukemic activity and prevent immune escape in KMT2A-rearranged acute lymphoblastic leukemia (KMT2Ar-ALL), a high-risk subtype common in infants. iNKT cells are used as the platform because they do not cause graft-versus-host disease (GVHD) and possess inherent trafficking advantages, such as VLA-4-mediated adhesion, which facilitates entry into the central nervous system to treat leptomeningeal disease. The therapy's mechanism of action involves both CAR-mediated cytotoxicity and NKG2D-dependent killing.
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