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**IL1RAP CAR-T cells + M-miR-142** is a combination therapy consisting of chimeric antigen receptor (CAR) T cells engineered to target interleukin-1 receptor accessory protein (IL1RAP), a surface marker selectively expressed on acute myeloid leukemia (AML) blasts and leukemic stem cells (LSCs) but absent on normal hematopoietic stem cells, and a synthetic microRNA-142 mimic (M-miR-142). The CAR construct uses a single-chain Fab (24scFab) fused to CD28 and CD3ζ costimulatory domains for potent antileukemic activity demonstrated in cell line-derived and patient-derived AML xenograft models. M-miR-142 counteracts leukemia-induced miR-142 deficiency in T cells, reducing apoptosis, lowering PD-1 expression, enhancing CAR-T persistence, promoting metabolic reprogramming, and overcoming immune suppression, resulting in significantly prolonged survival (e.g., median 78 days in PDX vs 51 days with CAR-T alone).[1][5][6]
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