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SAVVY-CAR T cells are second-generation chimeric antigen receptor (CAR) T cells engineered with a synthetic CD28 costimulatory domain, referred to as the SAVVY rheostat. This modification involves specific mutations within the CD28 signaling domain designed to attenuate PI3K/AKT/mTOR pathway signaling redundancies. By tempering these growth signals, SAVVY-CAR T cells aim to reduce T cell exhaustion and terminal differentiation, maintaining a more potent, memory-like immunophenotype. This technology has been applied to CARs targeting CD19 for B-cell malignancies and CD371 (CLL-1) for acute myeloid leukemia (AML). The CD371-directed version also features constitutive secretion of interleukin-18 (IL-18) to further enhance anti-tumor activity and is currently being evaluated in clinical trials.
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