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. 2020 Dec 31;218(2):e20200844. doi: 10.1084/jem.20200844

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© 2020 Xu et al.

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Figure 8. — Model of the activity of CAR T cells against breast cancer. The use of Th/Tc17 CAR T cells with enhanced proliferation and memory status (intrinsic modification) along with DMXAA/cGAMP to enhance trafficking and reduce immunosuppression in the TME (extrinsic modification) is critical for the effective antitumor response of CAR T cells against breast cancer (left). CAR T exhaustion (intrinsic resistance) and reversion back to an immunosuppressive TME state (extrinsic resistance) are associated with loss of CAR T cell function (middle). The addition of anti–PD-1 to overcome exhaustion (intrinsic modification) and the depletion of suppressive myeloid cells with anti–Gr-1 (extrinsic modification) leads to sustained tumor remission (right).