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ROR1 CAR-NK refers to a class of engineered cell therapies where natural killer (NK) cells are genetically modified to express a chimeric antigen receptor (CAR) targeting the receptor tyrosine kinase-like orphan receptor 1 (ROR1). ROR1 is an oncofetal antigen highly expressed in various hematologic malignancies, such as chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), as well as several solid tumors, while being largely absent from healthy adult tissues. A specific advanced iteration of this therapy is the tandem CD19/ROR1 CAR-NK, which utilizes a dual-targeting construct incorporating scFvs for both CD19 and ROR1 (the latter often derived from the monoclonal antibody zilovertamab). This tandem approach is designed to overcome resistance mechanisms, such as Wnt5a-mediated apoptotic resistance and antigen escape, by simultaneously targeting two tumor-associated antigens. These therapies are typically developed as allogeneic, off-the-shelf products derived from healthy donor sources, offering a potentially safer toxicity profile compared to autologous CAR-T cell therapies.
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