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From a cure for some leukaemias in 2017 to the first solid-tumour CAR-T and the prospect of making CAR-T inside the body with an injection.
This roadmap starts with the foundations of cell therapy, Rosenberg's TIL therapy in melanoma and the first-generation CARs, then the approvals of CD19 and BCMA CAR-T alongside T-cell engagers as off-the-shelf competitors. Blood cancers were the easy case with a clean antigen and accessible cells; the current step brings solid tumours within reach through lifileucel, afamitresgene autoleucel and CLDN18.2, GD2 and GPC3 CAR-T. The emerging manufacturing revolution covers gene-edited allogeneic products and in vivo CAR-T made inside the body by targeted LNPs or lentivirus, ending speculatively with in vivo CAR as an outpatient injection. The route links CAR-T, TIL, TCR-T, in vivo CAR-T, allogeneic cell therapy and CAR-NK, and is pointed to by glioblastoma and the manufacturing bottleneck.
Rosenberg's TIL therapy in melanoma (1988); first-generation CARs (Eshhar, 1989); 4-1BB and CD28 costimulation (June, Sadelain, Campana); Emily Whitehead treated with CTL019 (2012).
Tisagenlecleucel and axicabtagene (2017), then five more products; ZUMA-7 puts CAR-T ahead of transplant in second-line lymphoma; ide-cel and cilta-cel in myeloma; blinatumomab and teclistamab establish off-the-shelf T-cell engagers as competitors.
Solid-tumour cell therapy arrives: lifileucel (melanoma TIL, 2024), afamitresgene autoleucel (MAGE-A4 TCR-T, synovial sarcoma, 2024; age ≥12 in 2026), satri-cel (CLDN18.2 CAR-T, gastric, China 2025), GD2 CAR-T in neuroblastoma and glioma, GPC3 CAR-T in HCC. CAR-T expands to autoimmune disease.
Gene-edited allogeneic products (cema-cel, ALLO-316) show feasibility with persistence limits. In vivo CAR-T via targeted LNPs (Capstan/AbbVie, Orna) and lentivirus (Umoja, Interius) enter first-in-human trials with B-cell depletion and no lymphodepletion. iPSC-derived CAR-NK. CAR-T cost and access become policy issues.
Logic-gated and armoured CARs for solid tumours; neoantigen-specific TCR-T at scale via AI-predicted TCRs; in vivo CAR as an outpatient injection for lymphoma and autoimmune disease; CAR-T against fibroblast and myeloid targets; regional delivery for glioma, mesothelioma, and pancreatic cancer.
Every era's records, trial outcomes and papers, and every watch item, as JSON.
Probability ranges are named estimates that the claim is borne out on roughly a five-year horizon. They are meant to be argued with: propose a revision with your name and reasoning via a pull request to src/data/confidence.ts.
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Shares Glypican-3, Satricabtagene autoleucel, In vivo CAR-T, Claudin 18.2.
Shares Glypican-3, Satricabtagene autoleucel, Claudin 18.2, CAR-T cell therapy.
Shares MAGE-A4, In vivo CAR-T, TCR-T cell therapy.
Shares Ciltacabtagene autoleucel, Axicabtagene ciloleucel, Manufacturing cost and time for living and radioactive medicines, CAR-T cell therapy.
Shares Ciltacabtagene autoleucel, Axicabtagene ciloleucel, Manufacturing cost and time for living and radioactive medicines, CAR-T cell therapy.
Shares MAGE-A4, Afamitresgene autoleucel, TCR-T cell therapy.
Shares Armoured, logic-gated & next-gen CARs, CAR-NK & CAR-macrophage, TCR-T cell therapy, CAR-T cell therapy.
Shares MAGE-A4, Afamitresgene autoleucel, TCR-T cell therapy.