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Table 1 Current challenges with adoptive cell therapy for solid tumor

From: The “Great Debate” at Immunotherapy Bridge 2022, Naples, November 30th–December 1st, 2022

ACT approach

Challenges

ACT with tumor-infiltrating lymphocytes

Limited success rates

Most expanded TILs are irrelevant for tumor antigens

Prepared tumor-specific TILs have questionable tumor antigen specificity

TIL manufacturing process too long for patients to wait

Long TIL manufacturing process leads T cell exhaustion

Immune suppression in the TME limits TIL functions

High risk of adverse events from treatment and co-administered IL-2

CAR T cells/TCR-T cells

Requires suitable antigen targets that are not often available or adequately tumor-specific

Limited success across attempts with a variety of tumor antigens

Limited data on use of improved CARs with integrated controls

Difficulties in getting cell therapies to successfully traffic into solid tumor sites

Financial toxicity to the patient due to high costs of therapy, especially for underserved populations and for underinsured or uninsured patients

Increased risk of ”on-target off-tumor” toxicity