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Inducible caspase 9 (iCasp9) T cells are an adoptive cellular therapy platform incorporating a "safety switch" to mitigate severe adverse events. The system consists of a chimeric protein comprising a modified human pro-caspase 9 fused to a human FK506-binding protein (FKBP12). This construct remains inactive until the administration of a small-molecule chemical inducer of dimerization (CID), such as rimiducid (AP1903). Upon binding, the CID triggers the dimerization of caspase 9, activating the intrinsic apoptotic pathway and leading to the rapid elimination (within hours) of the gene-modified T cells. This technology is primarily used to control graft-versus-host disease (GVHD) in haploidentical stem cell transplantation and to manage toxicities like cytokine release syndrome in CAR-T therapies.
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