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CD19xCD22 CAR T-cells are an investigational bicistronic chimeric antigen receptor (CAR) T-cell therapy designed to simultaneously target CD19 and CD22 antigens on B-cell malignancies. This specific construct utilizes a dual-signaling approach, pairing a CD19-targeting CAR with a CD28 costimulatory domain and a CD22-targeting CAR with a 4-1BB costimulatory domain. By targeting two antigens, the therapy aims to reduce the risk of relapse caused by antigen-modulated escape (antigen loss). Preclinical data suggests that dual stimulation enhances T-cell signaling through the PLC-gamma 1 and NFAT pathways, leading to improved persistence, reduced exhaustion, and superior anti-tumor efficacy compared to single-target or other dual-target configurations. It is currently being evaluated in clinical trials for relapsed or refractory B-cell acute lymphoblastic leukemia (B-ALL) and other B-cell malignancies.
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