A research team from the Hematology Department of West China Hospital, Sichuan University (WCH), led by Professor Niu Ting and Associate Professor Zhao Ailin, recently published a review in Molecular Cancer (IF: 33.9) titled "Biomarker-empowered precision navigation of CAR-T cell therapy." The review systematically synthesizes host-derived, product-related, tumor-derived, and toxicity-associated biomarkers that influence the efficacy and safety of CAR-T therapy. It proposes a precision management strategy that moves from single candidate markers toward an integrated, longitudinal monitoring framework.
The review organizes the evidence along two dimensions: treatment workflow and biological source. It stratifies existing evidence across four categories – host, product, tumor, and toxicity – and analyzes the clinical application scenarios of different biomarkers at key nodes including pre-treatment evaluation, product manufacturing, post-infusion monitoring, response assessment, and long-term follow-up. It also discusses how emerging technological platforms – such as high-parameter flow cytometry, single-cell multi-omics, extracellular vesicle monitoring, allogeneic CAR-T, and in vivo CAR generation – are placing new demands on biomarker research.
The review highlights that precision management of CAR-T therapy cannot rely on a single indicator. Instead, a composite biomarker framework covering the entire treatment continuum is needed. Host status can inform pre-treatment risk assessment, product characteristics reflect cellular functional quality, tumor-related indicators help explain resistance and relapse, and toxicity biomarkers enable early identification of adverse events.
This work provides a systematic theoretical framework for transitioning CAR-T therapy from an experience-driven to a biomarker-driven paradigm. It also lays the groundwork for prospective validation studies, standardized testing protocols, and optimization of individualized treatment strategies.
Link to the paper: https://doi.org/10.1186/s12943-026-02647-0
