{"entity":{"id":"stroma-directed-car","kind":"technology","name":"CAR-T against stroma: fibroblasts and myeloid cells","aka":[],"tldr":"Instead of attacking the cancer cell, engineering T cells to strip away the scaffolding and the suppressive immune cells that protect it.","summary":"FAP-directed CAR-T depletes cancer-associated fibroblasts and, in mouse models, opens desmoplastic tumours to chemotherapy and immunity; a small Swiss study delivered FAP CAR-T into the pleural cavity in mesothelioma. Myeloid-directed approaches target CSF1R, TREM2, or CD163 populations. The recurring problem is that FAP and myeloid markers are not tumour-specific: FAP is expressed in bone-marrow stroma and healing tissue, and murine FAP CAR-T caused cachexia and marrow toxicity in early studies.","status":"preclinical","asOf":"2026-09-08","links":[{"label":"ClinicalTrials.gov: FAP CAR-T","url":"https://clinicaltrials.gov/search?term=FAP%20CAR-T"}],"tags":["frontier","radical"],"related":[],"cancers":["pancreatic","mesothelioma"],"sections":["cell-therapy","immunotherapy"],"technologies":["car-t","armored-car","fapi-pet"],"targets":["fap"],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"A CAR recognises a stromal antigen rather than a tumour antigen; killing the supporting cells collapses the niche the tumour depends on.","strengths":["Stroma is genetically stable, so it cannot mutate away","One construct could serve many cancers","Combines with drugs that stroma currently blocks"],"limitations":["On-target off-tumour toxicity: marrow, wound healing, cachexia","No registrational programme","Depleting stroma accelerated disease in some pancreatic models"]},"route":"/technologies/stroma-directed-car/","neighbours":{"cancer":[{"id":"mesothelioma","kind":"cancer","name":"Mesothelioma","route":"/cancers/mesothelioma/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"section":[{"id":"cell-therapy","kind":"section","name":"Cell Therapy","route":"/fronts/cell-therapy/"},{"id":"immunotherapy","kind":"section","name":"Immunotherapy","route":"/fronts/immunotherapy/"}],"technology":[{"id":"armored-car","kind":"technology","name":"Armoured, logic-gated & next-gen CARs","route":"/technologies/armored-car/"},{"id":"car-t","kind":"technology","name":"CAR-T cell therapy","route":"/technologies/car-t/"},{"id":"fapi-pet","kind":"technology","name":"FAPI PET","route":"/technologies/fapi-pet/"}],"target":[{"id":"fap","kind":"target","name":"FAP","route":"/targets/fap/"}],"roadmap":[{"id":"frontier-2035","kind":"roadmap","name":"Radical oncology: what could change the war by 2035","route":"/roadmaps/frontier-2035/"}],"pathway":[{"id":"caf-activation-desmoplasia","kind":"pathway","name":"Fibroblast activation, desmoplasia & matrix stiffness","route":"/pathways/caf-activation-desmoplasia/"}]}}