Adeno‐Associated Viral Vectors for Homology‐Directed Generation of CAR‐T Cells

Immunotherapy with T cells expressing chimeric antigen receptors (CAR) is an emerging and promising treatment against refractory cancers. However, the currently adopted methods of modification of T cells pose a risk of insertional oncogenesis because lentiviral and retroviral vectors integrate the CAR transgene in a semi‐random fashion. In addition, this therapy is only available using autologous cells, which create problems in production and limit the access for patients who have their T cells depleted. One modification method that shows the ability to overcome both drawbacks is the knock‐in of the CAR simultaneously knocking‐out genes that prevent allogeneic therapy, such as the endogenous T cell receptor. In this mini‐review, the authors present recent efforts to develop safer universal CAR‐T cells. More specifically, the combined application of target‐directed nucleases, which create a double‐strand break at a specific genome locus, and the delivery of CAR DNA via adeno‐associated viral vectors for subsequent integration via homologous recombination and silencing of the targeted gene is focused on.