Immune safety challenges facing the preclinical assessment and clinical progression of cell therapies

• Published in: Drug discovery today p. 104239
• Main Authors: Bates, Stephanie M., Evans, Kelly V., Delsing, Louise, Wong, Ryan, Cornish, Georgina, Bahjat, Mahnoush
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 08-11-2024
• Subjects: adverse immune response; CAR-T; cell therapy; drug development; immunotherapy; safety; drug development; CAR-T; cell therapy; adverse immune response; safety; immunotherapy
• ISSN: 1359-6446; 1878-5832; 1878-5832
• DOI: 10.1016/j.drudis.2024.104239

•Cell therapies can come with an extensive range of immune safety considerations, with different cell therapies presenting different safety risks.•There are limited preclinical models for assessing the immune safety risk of cell therapies.•Experiences with CAR-T therapies in the oncology space can provide guidance for preclinical and clinical mitigation strategies for broader disease indications.•Preclinical models that better predict the activity and safety profile in humans are critical to avoid unwanted adverse events in the clinic.
The promise of curative outcomes for life-limiting diseases using cell therapies is starting to become a reality, not only for patients with end-stage cancer, but also increasingly for regenerative therapies, including dentistry, ocular, neurodegenerative, and cardiac diseases. The introduction of often genetically modified cells into a patient can come with an extensive range of safety considerations. From an immune perspective, cell-based therapies carry inherent consequences and consideration of factors, such as the cell source (donor-derived autologous cells versus allogeneic cells), the intrinsic cellular nature of the therapy, and engineering/manufacturing methods, all of which influence the likelihood of inducing unwanted immune responses. Here, we provide an overview of the potential immune safety risks associated with cell therapies and explore possible mitigation approaches.