Table 3.

Pros and cons of autologous and allogeneic CAR-T therapy.

Immune Cell Source	Pros	Cons
Autologous	-Generally safer to infuse as there is no risk for other side effects beyond CAR mediated -No risk for HvG rejection, hence, cells may persist longer to induce more durable responses -Simpler manufacturing process, no need for additional genetic modifications -No need to search for other potential donors	-High treatment costs due to individualized nature, making one product for one patient -Poor quality and limited quantity of isolated immune cells -Potential manufacturing failures -Lengthy vein-to-vein time -Patients can experience disease progression or death while waiting for treatment -Not accessible to all patients
Allogeneic	-Off-the-shelf approach possible -Can use other immune cells other than T cells to potentially avoid GvHD -Genetic engineering techniques have advanced to help avoid treatment associated toxicities -More cost effective -Increased accessibility for all patients -Increased potential for multiple dosing if necessary -Can pre-screen donor cells to ensure that quantity and quality requirements can be met -Can potentially treat multiple patients with cells from one healthy donor -Increased speed between patient’s requirement for treatment and actual CAR-T cell infusion	-Potentially life-threatening GvHD can counteract any benefit of the treatment -HvG rejection can greatly limit cell persistence, hinder treatment efficacy and durability -Cost and complexity of techniques to avoid treatment associated toxicities might outweigh cost efficiency benefits of allogeneic approach

CAR = chimeric antigen receptor, GvHD = graft-versus-host disease, HvG = host-versus-graft.