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Maja Divjak, PhD (The Peter MacCallum Cancer Centre, Melbourne, Australia)
T cells are an important component of the immune system that protect us from infection and disease. T cells can detect abnormal molecules on the cell surface then kill those cells through release of cytotoxic molecules. Cancer cells can evade the immune system by altering their surface receptors, systematically avoiding destruction by T cells. Chimeric Antigen Receptor, or CAR-T cell therapy, is a revolutionary treatment using specially altered T cells to precisely target cancer cells. A patient’s own T cells are engineered to express Chimeric Antigen Receptors on the cell surface. When the CAR-T cells are infused into the patient, they multiply rapidly and can seek out and attack cancer cells throughout the body. Here is a CAR-T cell in cross section, with purple CARs spanning the turquoise cell membrane. The anti-CD19 binding domain glowing on the cell surface specifically binds to the CD19 receptor, expressed exclusively on immune cells known as B cells. When the CARs bind to CD19, the long signalling domains below the cell surface activate the CAR-T cell, which then destroys the B cell. These CAR-T cells therefore attack blood cancers such B-cell leukaemias and lymphomas