Novel toxicology challenges in the era of chimeric antigen receptor T-cells therapies

T-lymphocytes are fine executioners of adaptive immune-responses, however, quantitative and qualitative immunological defects in patients with cancer (1), together with tumor immune-evasion strategies can result in inefficient anti-tumor surveillance (2). Genetically engineered T-cells, redirected towards the CD19 antigen with chimeric antigen receptors (CARs), have proven successful in treating patients with relapsed/refractory acute lymphoblastic leukemia (ALL). In addition, CAR T-cells redirected towards tumor associated antigens are actively being investigated in a variety of malignancies, including solid cancers (3).