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CD19.CAR-CD28-CD137zeta is a third-generation chimeric antigen receptor (CAR) T-cell therapy. It involves genetically engineering autologous T-cells to express a CAR that specifically targets the CD19 protein found on B-cells, including cancerous B-cells. The CAR construct is characterized by the inclusion of an antigen-specific single-chain variable fragment (scFv) for CD19, a transmembrane region, and crucially, two intracellular co-stimulatory signaling domains: CD28 and CD137 (also known as 4-1BB). These co-stimulatory domains, along with the CD3-zeta (ζ) T-cell activation domain, work synergistically to enhance T-cell proliferation, cytokine production, and persistence upon binding to CD19, thereby leading to potent anti-tumor activity against CD19-expressing B-cell malignancies such as leukemia and lymphoma.
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