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. 2021 Mar 22;28(9):513–527. doi: 10.1038/s41434-021-00246-w

Fig. 1. Schematic illustration of a CAR-T or CAR-NK cell therapy, which uses primary immune cells.

Fig. 1

(1) T or NK cells are isolated from the patient’s or donor’s blood. (2) Subsequently, cells are genetically modified to express chimeric antigen receptors (CARs). (3) CAR-T or CAR-NK cells are expanded until sufficient cell numbers are attained and (4) (re-)injected into the patient’s body, where they can fight cancer cells. CAR constructs possess a targeting module that recognizes tumor antigens and either a single intracellular signaling domain (1. gen) or, one (2. gen), or two (3. gen) additional co-stimulatory domains. In most CAR constructs the targeting module consist of a single-chain variable fragment (scFv). Novel CAR constructs can also possess nanobodies, designed ankyrin repeat proteins (DARPins), ligands, or receptors instead of scFvs for target recognition. Adapter CARs consist of two components: a soluble antigen targeting module (TM) and a CAR which targets this TM. CAR chimeric antigen receptor, DARPins designed ankyrin repeat proteins, gen generation, scFv single-chain variable fragment, TM targeting module. This figure has been created using BioRender.