Mechanism of action

How CAR-T cell therapies work

Chimeric antigen receptor (CAR) T cell therapy involves collecting a patient’s own T cells, engineering them to recognize tumor-associated antigens, expanding them, and reinfusing them. Once back in the body, CAR-T cells identify their targets, activate, and destroy malignant cells.

The course of CAR-T therapy

The full process – from leukapheresis to transfusion of the final product – takes approximately 2 weeks.

The patient undergoes leukapheresis to collect the necessary number of T cells from the patient's blood.
Genetic engineering and expansion of CAR-T cells. After fulfilling the release criteria, the CAR-T cells are shipped back to the hospital. In the meantime, the patient undergoes preparative lymphodepletion chemotherapy at the treating institution to reduce the level of leukocytes in the blood.
After lymphodepletion, the patient receives a transfusion containing the CAR-T cells.
The newly inserted CAR allows the CAR-T cells to target the patient’s cancer cells.

Tandem CAR-Ts

Most CAR-T therapies are designed to recognize a single antigen (e.g., CD19 which is expressed on B-cells). In contrast, tandem CAR-T constructs incorporate two antigen-binding domains within a single CAR molecule, enabling recognition of two targets simultaneously. This approach may broaden malignant cell recognition and reduce tumor escape.

In B-cell malignancies, tumor cells can evade detection by downregulating a single antigen such as CD19. Zamto-cel, our lead investigational CAR-T therapy, is a tandem CD19-CD20 construct currently in pivotal trials for relapsed/refractory DLBCL, with additional disease areas under evaluation.

View the study list