T-killers (CAR-T therapy)
Immunotherapy is one of the most promising areas of oncology, aimed at teaching immunity to recognize and destroy cancer cells. CAR-T therapy occupies a separate place in immuno-oncology. Its uniqueness is that CAR-T-drugs are created from the blood components of a particular patient for his own individual treatment. To do this, white blood cells are taken from the patient's blood for genetic modifications in the T-lymphocyte genome. Then they are introduced into the body, and begin to successfully fight malignant cells.
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T-killers
Many pathogens are located inside the affected cells out of reach for humoral immunity factors (such as antibodies). To cope with intracellular parasites, a separate system of cellular acquired immunity arose, based on the functioning of T-killers. Chimeric receptor T cell therapy is called CAR-T therapy.
Killer T cells, or cytotoxic T cells, are white blood cells specializing in the defeat of viruses and tumor cells. There are about five million of them in one teaspoon of blood.
T-killers directly contact damaged cells and destroy them. Unlike NK cells, T-killers specifically recognize a specific antigen and kill only cells with this antigen. There are tens of millions of T-killer clones, each of which is "tuned" to a specific antigen.
In the video below, T-killers kill a cancer cell.
The mechanism of operation of these cells is interesting. Once the T-killer detects the cancer cell, the membrane "fingers" of the lymphocyte test it. After such "identification," the T-killer binds to the cell and injects poisonous proteins (shown in red in the video) into microtubules on its surface. Finally, the white blood cell punctures this surface, allowing the poisonous cargo to destroy the cancer cell.
History
2025
The use of the first Russian CAR-T therapy began. Cancer is treated with it
In Russia, for the first time, a patient was treated using a domestic individual biomedical cell product anti-CD19 CAR-T. The therapy was received by a man diagnosed with diffuse B-large cell lymphoma - one of the most common and aggressive forms of this disease. The cell product was manufactured under the conditions of the Scientific and Production Complex of the National Medical Research Center of Radiology of the Ministry of Health of Russia in accordance with GMP standards. This was reported in the MNII named after P.A. Herzen - a branch of the National Medical Research Center of Radiology of the Ministry of Health of Russia on October 2, 2025. Read more here.
Multiple sclerosis first started successfully treated with CAR-T therapy
In early August 2026, American specialists from Nebraska Medicine reported the successful use of CAR-T therapy for the treatment of multiple sclerosis. This procedure was carried out for the first time in the world.
CAR-T therapy is used to treat certain forms of cancer, in particular lymphomas and acute leukemias. The technology involves the introduction of genetically modified cells of the patient's immune system into the body. A person's own T lymphocytes are altered by attaching to them an artificially created receptor aimed at killing a certain type of tumor cell. After administration back to the patient, CAR-T cells independently find and destroy the malignancy.
Nebraska Medicine specialists have adapted the method to fight multiple sclerosis. It is an autoimmune disease leading to damage to the insulating membranes of nerve cells in the brain and spinal cord. The ailment is often expressed in problems with vision, fatigue, impaired walking and balance, as well as numbness and a feeling of weakness in the hands and feet.
The first patient with multiple sclerosis to undergo CAR-T therapy was 49-year-old Jan Janisch-Hanzlik. She has experienced negative symptoms for years that impair her quality of life. During the procedure, genetically modified donor T cells were used. The challenge was to track a small marker of CD19 on B cells (a functional type of lymphocytes that play an important role in providing humoral immunity) involved in multiple sclerosis processes. After administration, the modified T cells destroy the labeled cells and essentially reboot the immune system. Experts say that this is a completely new concept in the therapy of multiple sclerosis.[1]
The National Medical Research Center of Hematology was the first in Russia to launch the production of a CAR-T cell product
The National Medical Research Center for Hematology of the Ministry of Health of Russia became the first medical institution in the country to receive a full set of licenses for the production of CAR-T-cell products for the treatment of oncohematological diseases. Roszdravnadzor issued a license to the center for the production of biomedical cell products, including individual drugs for the therapy of blood malignancies. This became known on July 22, 2025. Read more here.
The first CAR-T therapy against cancer in Russia was held in Moscow
Doctors of the Morozov Children's Hospital conducted the first industrial CAR-T therapy against cancer in Russia, using an innovative technology to treat a 12-year-old patient with a recurrence of acute lymphoblastic leukemia. The procedure was completed successfully, and the child is already at home under the supervision of specialists. The capital's mayor Sergei Sobyanin announced this at the end of June 2025. Read more here.
In Russia, developed the technology of killing cancer cells with the help of T-lymphocytes
The technology for combating oncology, based on the modification of T-lymphocytes inside the body, was developed Russia by scientists at the University of Science and Technology. " Sirius A new approach to CAR-T therapy allows targeted killing of cancer cells, minimizing the side effects of traditional cell treatments. The press service of the university announced the development of a method that does not require preliminary extraction of cells in mid-June 2025.
According to TASS, the new method allows you to tune your own cells of the human immune system to destroy cancer cells without extracting them from the body. The researchers achieved significant primary results that demonstrate the high efficacy of modified cells in eliminating tumors in a laboratory setting.
The developed technology is radically different from the existing methods of CAR-T therapy. The traditional technique requires the extraction of immune cells from the patient's blood, their modification in the laboratory and subsequent return to the body. Russian experts have proposed a way to teach T-lymphocytes how to fight the disease directly inside the patient's body.
The basis of the new technology was the introduction into T cells of a special "sensor" - a chimeric antigenic receptor (CAR). This receptor helps immune cells recognize tumor cells from characteristic markers on their surface. Scientists focused on the CD19 protein located on the surface of cancer B-lymphocytes, which cause lymphoma - a malignant tumor of the blood and lymphatic tissue.
The researchers also work with markers of blood plasma cells. With the malignant transformation of these cells, multiple myeloma develops - a rare but severe form of blood cancer. CAR-T cells are designed to recognize specific proteins and destroy only cells with appropriate markers.[2]
What side effects cause the most successful CAR-T cancer immunotherapy
On May 12, 2025, American experts Stanford University from published the results of a study stating that immunotherapies cancer CAR-T can provoke minor cognitive violations. They can be expressed, in particular, in the form of blurred consciousness.
CAR-T is a therapy using genetically modified cells of the patient's own immune system. In this method, a person's own T lymphocytes are altered by attaching to them an artificially created receptor aimed at killing a certain type of tumor cell. After administration back to the patient, CAR-T cells independently find and destroy the malignancy. This immunotherapy is effective even in cases where other methods, such as chemoradiotherapy or targeted drugs, do not produce the desired result.
However, some patients who have undergone CAR-T therapy complain of minor memory problems and other cognitive impairments. To determine the cause of such side effects, scientists injected mice with cell cultures of five different forms of cancer, and after the formation of tumors, they tried to destroy them with CAR-T therapy. Before and after the procedure, the researchers used standard cognitive tests, assessing how rodents respond to the appearance of a new object and go through a simple maze. It turned out that immunotherapy did impair the cognitive abilities of mice.
Subsequent analysis showed that CAR-T therapy provoked changes in the function of auxiliary cells in the white matter of the brain. In particular, two types of cells - microglia and oligodendrocytes - began to produce a large number of signaling molecules that contribute to the development of inflammation and damage to the myelin sheath of the nerve endings. Because of this, cognitive impairment is observed.[3]
CAR-T therapy is used only in one medical center in Russia - Dima Rogachev Center
By 2025, in Russia, over 6.5 years, the experience of using CAR-T in the framework of hospital production has accumulated - for a specific patient in a specific medical organization. At the same time, the efficiency of production and the success of treatment is more than 95%. Such data were provided at the forum in April 2025 by Mikhail Maschan, Deputy General Director for Science, Director of the Institute of Molecular and Experimental Medicine of the Dima Rogachev Center.
According to him, the first patient received such therapy in 2018, since then more than 150 Russian patients have received more than 190 CAR-T products.
"In hospital manufacturing, we can produce such drugs more than effectively. Survival results and long-term remission are comparable to those published in research materials on industrial drugs, "says Professor Maschan.
Despite the impressive results, CAR-T therapy is still applied in only one medical center in the country due to regulatory barriers.
One of the key obstacles is the question of how to define CAR-T drugs - as medical technology or as drugs. In those countries where CAR-T therapy received approval for market use, this dispute was resolved in favor of the second option.
According to Mikhail Maschan, in order to develop this direction within the framework of hospital production, it is necessary to concentrate resources in academic medical centers, national medical centers and federal universities. To do this, among other things, you need to invest in clinical research, and these centers should initiate them.
"Hospital exceptions" (academic production) is one of the most effective ways to speed up the development and use of CAR-T therapy in Russia, says Nextons partner Sergei Klimenko. But in the Russian legislation on the circulation of medicines there are no points according to which it would be possible to produce high-tech medicines in a medical organization, since this, for example, is prescribed in relation to biotechnological (BTLP) and biomedical medicines (BMCP). At the same time, the model of BMCP and BTLP under Art. 13 (5) (8) 61-FZ is also not optimal, since it requires all production operations within the walls of a medical organization and excludes the possibility of creating so-called "collective use centers," thus limiting the possibility of transferring technologies from the commercial segment to the "academic," speed of implementation, etc.
In addition, in order to develop CAR-T therapy, it is necessary to work out document management issues related to obtaining consent from patients, storing and transferring genetic material.
Successful completion of the first stage of clinical trials of the domestic CAR-T-cell drug Utzhefra
The National Medical Research Center (NMSC) of Hematology of the Ministry of Health of Russia in January 2025 announced the successful completion of the first stage of clinical trials of the domestic CAR-T-cell drug Utzhefra in the first patient with blood cancer. Read more here.
2024
First CAR-T cell therapy in Russia approved
On November 12, 2024, the Ministry health care Russia issued permission to the National Medical Research Center of Hematology to conduct clinical trials of the first domestic CAR-T drug Utzhefra (hemagenlekleutzel). More. here
For the first time in history, sclerosis and myopathy were cured by donor cells
In early October 2024, Chinese researchers at the Naval Medical University in Shanghai reported that they had managed to cure autoimmune diseases for the first time in history with donor immune cells. This achievement is the first step towards the introduction of new methods of therapy for severe ailments.
Three patients reportedly received CAR-T cell therapy based on donor cells. Usually, this method involves the use of the patient's own cells, which are genetically programmed and then returned to the human body. In the new work, donor material was used: immune cells were previously modified using CRISPR gene editing, and then introduced into the body of patients.
One of the patients was a 42-year-old woman with autoimmune myopathy, a disease in which skeletal muscle tissue is affected. In addition, men aged 45 and 57 with systemic sclerosis received the new therapy: it is a rare chronic autoimmune connective tissue disease, in which degenerative changes and scarring of the skin, joints and internal organs are observed, as well as pathological changes in blood vessels. After administration, T cells destroyed pathogenic B cells that provoked an autoimmune reaction in the body.
As a result, two months after treatment, the woman achieved complete remission, which, as of October 2024, lasts six months. Both men also experienced significant improvement in symptoms, including cessation of scar tissue formation. At the same time, none of the patients showed a pronounced inflammatory reaction, known as cytokine release syndrome, which is observed in some people with cancer who received CAR-T therapy.[4]
Blokhin National Medical Research Center received expensive equipment for CAR-T therapy
The National Medical Research Center (NMSC) of Oncology named after N.N. Blokhin completed the installation and put into operation expensive equipment for the production of CAR-T cells. This became known on September 26, 2024. Read more here
The new CAR T cell therapy copes with lymphoma even after relapse. People are already recovering
In mid-July 2024, researchers at Stanford Medical University presented new data on CAR-T cell therapies that help some patients with intractable lymphoma even after relapse.
CAR-T cell therapy involves extracting a patient's immune cells, adding a gene that helps those cells attack a specific protein on the surface of lymphoma cells, and then returning the modified immune cells to the body. Using the first options for this type of therapy, the researchers were able to achieve tumor reduction or disappearance in about half of patients with large B-cell lymphoma who did not respond to standard chemotherapy. However, with the failure of CAR-T cell therapy, which was observed in about half of the patients, the cancer returned, and the prognosis was extremely unfavorable.
Using an approach in which the target of modified immune cells instead of the CD19 protein was the tumor protein CD22, the researchers were able to significantly improve the treatment outcomes of these patients: more than half of the 37 people who relapsed after initial CAR-T cell therapy were able to achieve a complete response. Thanks to this, life expectancy after relapse rose from 6 months to at least two years after the new treatment.
Initially, the study took place from 2022 to 2024 entirely at Stanford University. In 2024, a larger second phase of the study was launched in several institutions. USA Six CAR-T cell therapies have already been approved for several types of lymphoma, multiple myeloma and acute lymphoblastic leukemia, four of these therapies use the CD19 protein as a target, two more target another protein on the cell surface called the B cell maturation agent. The favorable results of the study may be the basis for the approval of a new variant of CAR-T-cell therapy that affects the CD22 protein.
New immunotherapy provides 100% cancer remission in patients
On January 4, 2024, Swiss researchers from the Lausanne Federal Polytechnic School (EPFL) reported new advances in CAR-T cell therapy in the treatment of malignant tumors. Scientists have managed to achieve 100% cancer remission in patients. Read more here.
2023
CAR T therapy coped with lupus and other autoimmune diseases in all patients
On December 9, 2023, the American Society of Hematology (ASH) reported that CAR T therapy had achieved complete drug-free remission in patients with systemic lupus erythematosus and other autoimmune diseases. The findings may offer hope for safe and effective treatment for many people suffering from severe ailments.
CAR T therapy is originally designed to treat blood cancer, in which antibody-producing B cells start dividing uncontrollably. The technology is a method of treating cancer patients with the help of their own immune cells, which are specially modified in laboratory conditions. After infusion, these specially prepared cells function as a tumor-oriented drug.
The aim of the new study was to investigate whether CAR T therapy is effective in autoimmune diseases. Such ailments develop due to the pathological production of autoimmune antibodies or the proliferation of autoaggressive clones of killer cells against healthy tissues of the body. Experts selected 15 patients with severe systemic lupus erythematosus, idiopathic inflammatory myopathy and systemic sclerosis. They received a single infusion of modified immune cells. After that, patients stopped taking immunosuppressants.
Three months after therapy, all patients with systemic lupus erythematosus achieved complete remission and showed no symptoms of the disease. Moreover, as noted, they do not require any additional treatment. People with myopathy who underwent therapy also achieved remission, whereas patients with systemic sclerosis showed significant improvement in symptoms without exacerbation of the disease.[5]
Cases of cancer after CAR-T cell therapy
On November 28, 2023, the U.S. Food and Drug Administration (FDA) initiated a review in connection with the results of clinical studies related to CAR-T cell therapy. Reports suggest that the use of this method may provoke the development of additional malignancies as side effects.
CAR-T-cell therapy is a method of treating cancer patients with the help of their own immune cells, which are specially modified in laboratory conditions. After infusion, these specially prepared cells function as a tumor-targeting drug. By the end of November 2023, the FDA had approved six CAR-T methods: Abecma (idecabtagen vicleucel), Breyanzi (lysocabtagen maraleucel), Carvykti (cyltacabtagen autolecel), Kymriah (tisagenleukleucel), Tecartus (brexukabtagen autolecel) and Yescarta (axicolabtagel). They are designed to treat blood cancers, including lymphomas and some types of leukemia.
The FDA notice says the overall benefits of the listed products outweigh the potential risks from their use. Nevertheless, due to the likelihood of the development of secondary malignancies, the regulator conducts an additional safety check. Based on its results, conclusions will be made about the need to take certain measures.
It is noted that the greatest fears are caused by the Kymriah product of Novartis AG. The regulator's adverse events database indicates that this therapy is associated with much more frequent cases of malignancies than other similar treatments. By the end of November 2023, more than 10 thousand patients received Kymriah therapy, and Novartis did not reveal a causal relationship between the treatment and secondary malignancies.[6]
2022: Unique CAR-T cell therapy in Russia, replacing toxic chemotherapy
As it became known in April 2022, the National Medical Research Center of Hematology and the Dmitry Rogachev National Medical Research Center of Hematology jointly conducted CAR-T therapy in a patient with mantle zone cell lymphoma (a variant of B-cell non-Hodgkin lymphoma). This is the first experience in Russia in using CAR-T as the first line (after targeted therapy) in an adult patient.
According to Kommersant, CAR-T cell therapy is a treatment method based on the use of the patient's own cells. T lymphocytes are extracted from the patient's body using apheresis, a technology that allows blood to be divided into components and a certain number of lymphocytes can be obtained. Their modification is then done so that they can recognize and attack the tumor cells and they are injected back into the patient's body.
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The 68-year-old Russian was diagnosed with lymphoma from the cells of the mantle zone, the so-called blastoid version is an extremely aggressive course, explained Evgeny Zvonkov, head of the intensive high-dose lymphoma chemotherapy department of the National Medical Research Center of Hematology. Subsequently, genetic breakdowns associated with absolute resistance to standard chemotherapy were found. Because of this, doctors were forced to apply a targeted effect in the first line, which allows them to bypass the signaling pathway associated with a mutation in the TR53 gene.
According to Zvonkov, the drugs ibrutinib and venetoclax have minimal toxicity, but, as it turned out, are extremely effective.
 | A week later, almost nothing remained of the tumor, instead of 1.5 million white blood cells, 700 became, and the spleen, the size of which was 30 cm, became normal, platelets and hemoglobin recovered. Before us was actually a healthy person, - said Evgeny Zvonkov. |  |
Notes
- ↑ 'A monumental day': Nebraska Medicine offers world-first experimental treatment
- ↑ In "Sirius" taught T-lymphocytes to destroy cancer cells
- ↑ Study links CAR-T cell cancer therapy to ‘brain fog’
- ↑ World-first therapy using donor cells sends autoimmune diseases into remission
- ↑ CAR-T, recently used in a lupus patient, helps other autoimmune patients, too, in small study
- ↑ FDA Investigating Serious Risk of T-cell Malignancy Following BCMA-Directed or CD19-Directed Autologous Chimeric Antigen Receptor (CAR) T cell Immunotherapies
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