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. 2023 Apr 12;21:255. doi: 10.1186/s12967-023-04080-z

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© The Author(s) 2023

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 7 — Schema: Sequential Therapy enhances the antitumor ability of CAR-T by suppressing the infiltration of MDSCs. Left: CAFs are crucial in TME, forming an immune surveillance barrier and perpetuating tumor-promoting. The CAFs could also promote recruit monocytes from the bone marrow, such as MDSCs, to form a tumor-suppressing microenvironment, suppressing CAR-T cell function. Right: FAP-targeted CAR-T cells eliminate CAFs via specific recognition of FAP on CAFs in the tumor microenvironment. Further, CLDN18.2-targeted CAR-T cells could also increase cytotoxic T cells and inhibit the recruiting of MDSCs. With an improved immune suppressive microenvironment, the antitumor effect of the sequential infusion of CLDN18.2-targeted CAR-T cells were enhanced