Fig. 2.

Resistance mechanisms to CAR T cell therapy independent of target antigen loss. A Expression of inhibitory ligands (such as PD-L1) by tumor cells inhibit CAR T cell cytotoxicity despite target antigen recognition by CAR. B Lack of CD58 expression by tumor cells prevent CD2 to deliver a costimulatory to CAR T cell resulting in an impaired cytotoxicity despite target antigen recognition by CAR. C Impaired apoptotic machinery in tumor cells confer intrinsic tumor cell resistance to CAR T cell mediated immune killing despite target antigen recognition by CAR