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Vadacabtagene leraleucel (JCAR015) is an autologous chimeric antigen receptor (CAR) T-cell therapy designed to target the CD19 antigen. It involves genetically modifying a patient's own T-cells to express a CAR that includes an anti-CD19 single-chain variable fragment (scFv) for antigen recognition, a CD28 co-stimulatory domain, and a CD3 zeta signaling domain. This construct enables the modified T-cells to specifically recognize and bind to CD19-expressing B-cells, including malignant B-cells found in certain leukemias and lymphomas. Upon binding, the CAR-T cells activate, proliferate, and release cytotoxic molecules and cytokines, leading to the lysis of targeted cancer cells. Developed by Juno Therapeutics, its development for B-cell acute lymphoblastic leukemia was terminated in 2017 due to severe neurotoxicity, specifically cerebral edema, observed in clinical trials.
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