# Beyond CAR-T and oncology: broadening chimeric antigen receptor technologies across cell types and diseases

**Authors:** Xiaohong Liu, Hongye Gao, Jianhua Yu

PMC · DOI: 10.1093/pcmedi/pbag007 · 2026-02-23

## TL;DR

This review explores how CAR technology, beyond its use in cancer, can be applied to various cell types and diseases, offering new therapeutic possibilities.

## Contribution

The paper introduces the expansion of CAR technology into non-traditional cell types and non-oncology diseases.

## Key findings

- CAR technology is being extended to unconventional immune and non-immune cell types.
- CAR platforms show potential in treating autoimmune diseases, infections, and fibrosis.
- Diverse CAR platforms offer complementary therapeutic advantages and manufacturing approaches.

## Abstract

Chimeric antigen receptor (CAR)-engineered immune cells have revolutionized cancer immunotherapy, expanding from the established success of CAR-T cells to a diverse array of cellular platforms. While seven Food and Drug Administration-approved CAR-T cell products demonstrate unprecedented efficacy in hematologic malignancies, significant limitations persist, including severe inflammatory toxicities, resistance in solid tumors, and manufacturing barriers. These challenges have catalyzed extensive research to extend CAR engineering into alternative effector cell types, such as unconventional T cell subsets, natural killer (NK) cells, macrophages, neutrophils, and dendritic cells, as well as non-immune platforms. Each cell type exhibits distinct antitumor mechanisms, persistence profiles, safety characteristics, and manufacturing requirements, positioning them to address complementary therapeutic needs. This review provides a comprehensive overview of diverse CAR-engineered cellular platforms, encompassing their biological properties, advantages, sourcing strategies, and manufacturing processes, alongside current clinical progress and optimization approaches. Beyond oncology, these platforms have demonstrated significant potential in treating autoimmune diseases, infections, cardiac fibrosis, and senescence-associated disorders. By leveraging distinct immune and non-immune cell types to mediate cytotoxicity or suppress pathogenic cells, CAR technology provides versatile therapeutic avenues across varied disease contexts. Through synthesis of recent advances in CAR platform diversity, this review identifies opportunities for targeted optimization and explores future directions for broadening CAR-based therapeutic applications.

## Linked entities

- **Diseases:** cancer (MONDO:0004992)

## Full-text entities

- **Genes:** MUC1 (mucin 1, cell surface associated) [NCBI Gene 4582] {aka ADMCKD, ADMCKD1, ADTKD2, CA 15-3, CD227, Ca15-3}, IL7 (interleukin 7) [NCBI Gene 3574] {aka IL-7, IMD130}, CD28 (CD28 molecule) [NCBI Gene 940] {aka IMD123, Tp44}, TRAJ18 (T cell receptor alpha joining 18) [NCBI Gene 28737], Tnf (tumor necrosis factor) [NCBI Gene 21926] {aka DIF, TNF-a, TNF-alpha, TNFSF2, TNFalpha, Tnfa}, CXCR6 (C-X-C motif chemokine receptor 6) [NCBI Gene 10663] {aka BONZO, CD186, CDw186, STRL33, TYMSTR}, NR1I3 (nuclear receptor subfamily 1 group I member 3) [NCBI Gene 9970] {aka CAR, CAR1, MB67}, Il6 (interleukin 6) [NCBI Gene 16193] {aka Il-6}, ERBB2 (erb-b2 receptor tyrosine kinase 2) [NCBI Gene 2064] {aka CD340, HER-2, HER-2/neu, HER2, MLN 19, MLN-19}, CD70 (CD70 molecule) [NCBI Gene 970] {aka CD27-L, CD27L, CD27LG, LPFS3, TNFSF7, TNLG8A}, Spi1 (Spi-1 proto-oncogene) [NCBI Gene 20375] {aka Dis-1, Dis1, PU.1, Sfpi-1, Sfpi1, Spi-1}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, TNFRSF17 (TNF receptor superfamily member 17) [NCBI Gene 608] {aka BCM, BCMA, CD269, TNFRSF13A}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, IDO1 (indoleamine 2,3-dioxygenase 1) [NCBI Gene 3620] {aka IDO, IDO-1, INDO}, PDCD1 (programmed cell death 1) [NCBI Gene 5133] {aka ADMIO4, AIMTBS, CD279, PD-1, PD1, SLEB2}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, CD40 (CD40 molecule) [NCBI Gene 958] {aka Bp50, CDW40, TNFRSF5, p50}, Entpd1 (ectonucleoside triphosphate diphosphohydrolase 1) [NCBI Gene 12495] {aka 2610206B08Rik, ATP-DPH, Cd39, E130009M23Rik, NTPDase-1}, CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, Il1b (interleukin 1 beta) [NCBI Gene 16176] {aka IL-1beta, Il-1b}, CXADRP1 (CXADR pseudogene 1) [NCBI Gene 653108] {aka CAR, CXADRP}, ZAP70 (zeta chain of T cell receptor associated protein kinase 70) [NCBI Gene 7535] {aka ADMIO2, IMD48, SRK, STCD, STD, TZK}, MEGF10 (multiple EGF like domains 10) [NCBI Gene 84466] {aka CMYO10A, CMYO10B, CMYP10A, CMYP10B, EMARDD, SR-F3}, NT5E (5'-nucleotidase ecto) [NCBI Gene 4907] {aka CALJA, CD73, E5NT, NT, NT5, NTE}, Il9r (interleukin 9 receptor) [NCBI Gene 16199], BTN2A1 (butyrophilin subfamily 2 member A1) [NCBI Gene 11120] {aka BK14H9.1, BT2.1, BTF1, BTN2.1, DJ3E1.1}, CD19 (CD19 molecule) [NCBI Gene 930] {aka B4, CVID3}, IL4 (interleukin 4) [NCBI Gene 3565] {aka BCGF-1, BCGF1, BSF-1, BSF1, IL-4}, TRAV10 (T cell receptor alpha variable 10) [NCBI Gene 28676] {aka TCRAV10S1, TCRAV24S1}, Cd226 (CD226 antigen) [NCBI Gene 225825] {aka DNAM-1, DNAM1, Pta1, TLiSA1}, KLRK1 (killer cell lectin like receptor K1) [NCBI Gene 22914] {aka CD314, D12S2489E, KLR, NKG2-D, NKG2D}, CLDN6 (claudin 6) [NCBI Gene 9074], LCK (LCK proto-oncogene, Src family tyrosine kinase) [NCBI Gene 3932] {aka IMD22, LSK, YT16, p56lck, pp58lck}, HLA-E (major histocompatibility complex, class I, E) [NCBI Gene 3133] {aka HLA-6.2, QA1}, KRAS (KRAS proto-oncogene, GTPase) [NCBI Gene 3845] {aka 'C-K-RAS, C-K-RAS, CFC2, K-RAS2A, K-RAS2B, K-RAS4A}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, IL12B (interleukin 12B) [NCBI Gene 3593] {aka CLMF, CLMF2, IL-12B, IMD28, IMD29, NKSF}, KIR2DL3 (killer cell immunoglobulin like receptor, two Ig domains and long cytoplasmic tail 3) [NCBI Gene 3804] {aka CD158B2, CD158b, GL183, KIR-023GB, KIR-K7b, KIR-K7c}, CCL19 (C-C motif chemokine ligand 19) [NCBI Gene 6363] {aka CKb11, ELC, MIP-3b, MIP3B, SCYA19}, CCR2 (C-C motif chemokine receptor 2) [NCBI Gene 729230] {aka CC-CKR-2, CCR-2, CCR2A, CCR2B, CD192, CKR2}, IL18 (interleukin 18) [NCBI Gene 3606] {aka IGIF, IL-18, IL-1g, IL1F4}, CD47 (CD47 molecule) [NCBI Gene 961] {aka IAP, MER6, OA3}, CD1D (CD1d molecule) [NCBI Gene 912] {aka R3, R3G1}, Tgfb1 (transforming growth factor, beta 1) [NCBI Gene 21803] {aka TGF-beta1, TGFbeta1, Tgfb, Tgfb-1}, TRAV11 (T cell receptor alpha variable 11 (pseudogene)) [NCBI Gene 28675] {aka TCRAV11S1}, BTN3A1 (butyrophilin subfamily 3 member A1) [NCBI Gene 11119] {aka BT3.1, BTF5, BTN3.1, CD277}, IL17A (interleukin 17A) [NCBI Gene 3605] {aka CTLA-8, CTLA8, IL-17, IL-17A, IL17, ILA17}, Cd4 (CD4 antigen) [NCBI Gene 12504] {aka L3T4, Ly-4}, Irf4 (interferon regulatory factor 4) [NCBI Gene 16364] {aka IRF-4, LSIRF, NF-EM5, Spip}, FASLG (Fas ligand) [NCBI Gene 356] {aka ALPS1B, APT1LG1, APTL, CD178, CD95-L, CD95L}, Il9 (interleukin 9) [NCBI Gene 16198] {aka Il-9, P40}, Ythdf2 (YTH N6-methyladenosine RNA binding protein 2) [NCBI Gene 213541] {aka 9430020E02Rik, HGRG8, NY-REN-2}, TRAJ60 (T cell receptor alpha joining 60 (pseudogene)) [NCBI Gene 28695] {aka TCRA}, MSLN (mesothelin) [NCBI Gene 10232] {aka MPF, SMRP}, Cd274 (CD274 antigen) [NCBI Gene 60533] {aka A530045L16Rik, B7h1, Pdcd1l1, Pdcd1lg1, Pdl1}, FOXP3 (forkhead box P3) [NCBI Gene 50943] {aka AIID, DIETER, IPEX, JM2, PIDX, XPID}, TIGIT (T cell immunoreceptor with Ig and ITIM domains) [NCBI Gene 201633] {aka VSIG9, VSTM3, WUCAM}, MR1 (major histocompatibility complex, class I-related) [NCBI Gene 3140] {aka HLALS}
- **Diseases:** chronic infections (MESH:D000088562), B cell aplasia (MESH:D015448), glioblastoma (MESH:D005909), EAE (MESH:D004681), diseases (MESH:D004194), confusion (MESH:D003221), prostate cancer (MESH:D011471), acute myeloid leukemia (MESH:D015470), MS (MESH:D009103), lung cancer (MESH:D008175), cardiac fibrosis (MESH:D005355), leukemia (MESH:D007938), Tumor (MESH:D009369), hypotension (MESH:D007022), multiple myeloma (MESH:D009101), ICANS (MESH:C000722498), multi-organ failure (MESH:D009102), alloimmune and (MESH:C536394), inflammatory bowel disease (MESH:D015212), gliomas (MESH:D005910), CD5+ T cell lymphoma (MESH:D016399), vitiligo (MESH:D014820), HIV infection (MESH:D015658), neuroblastoma (MESH:D009447), infection (MESH:D007239), SLE (MESH:D008180), Autoimmune diseases (MESH:D001327), diabetes (MESH:D003920), B-ALL (MESH:D054198), liver fibrosis (MESH:D008103), colorectal cancer (MESH:D015179), solid (MESH:D018250), pancreatic cancer (MESH:D010190), thrombocytopenia (MESH:D013921), cytopenia (MESH:D006402), seizures (MESH:D012640), CIML (MESH:D000080424), oncologic (MESH:D000072716), B-cell acute lymphoblastic leukemia (MESH:D015456), inflammation (MESH:D007249), oral cancer (MESH:D009062), rheumatoid arthritis (MESH:D001172), hematologic and solid malignancies (MESH:D019337), systemic sclerosis (MESH:D012595), acute encephalopathy (MESH:D000071072), B-cell malignancies (MESH:D016393), cytotoxic (MESH:D064420), breast cancer (MESH:D001943), cardiovascular diseases (MESH:D002318), leukopenia (MESH:D007970), immune (MESH:D007154), DNT (MESH:D001260), fever (MESH:D005334), hypoxic (MESH:D002534), NHL (MESH:D008228), infectious complications (MESH:D003141), GvHD (MESH:D006086), cerebral edema (MESH:D001929), hemophilia (MESH:D006467), asthma (MESH:D001249)
- **Chemicals:** rapamycin (MESH:D020123), ADI-001 (-), ROS (MESH:D017382), Tocilizumab (MESH:C502936), glycolipids (MESH:D006017), nitric oxide (MESH:D009569), ZOL (MESH:D000077211), Dexamethasone (MESH:D003907), lipid (MESH:D008055), retinoic acid (MESH:D014212), 5-(2-oxopropylideneamino)-6-D-ribitylaminouracil (MESH:C000654742), adenosine (MESH:D000241), alpha-galactosylceramide (MESH:C493154)
- **Species:** Human immunodeficiency virus 1 (no rank) [taxon 11676], Severe acute respiratory syndrome coronavirus 2 (no rank) [taxon 2697049], Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606]
- **Cell lines:** K562 — Homo sapiens (Human), Blast phase chronic myelogenous leukemia, BCR-ABL1 positive, Cancer cell line (CVCL_0004), THP-1 — Homo sapiens (Human), Childhood acute monocytic leukemia, Cancer cell line (CVCL_0006), Th9 — Homo sapiens (Human), Transformed cell line (CVCL_8306), T9 — Homo sapiens (Human), Human papillomavirus-related endocervical adenocarcinoma, Cancer cell line (CVCL_M092), CAR-T9 — Mus musculus (Mouse), Transformed cell line (CVCL_WN86), NK92 — Homo sapiens (Human), Natural killer cell lymphoblastic leukemia/lymphoma, Cancer cell line (CVCL_2142), RD114 — Homo sapiens (Human), Embryonal rhabdomyosarcoma, Cancer cell line (CVCL_1751), MAIT — Homo sapiens (Human), Finite cell line (CVCL_0084)

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12983217/full.md

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Source: https://tomesphere.com/paper/PMC12983217