Supercharging CAR-T cells through transcriptional and epigenetic armoring

Theranostics. 2025 Feb 18;15(8):3345-3367. doi: 10.7150/thno.107908. eCollection 2025.

Abstract

Inspired by the remarkable success of CAR-T therapy in hematologic malignancies, research is increasingly focused on adapting this treatment for solid tumors. However, CAR-T efficacy remains limited due to its exhaustion and shortened persistence. Transcription factors and epigenetic modifications play pivotal roles in modulating T cell differentiation and functionality, which have been leveraged in numerous strategies to promote the formation of long-lasting memory cells with stem-like properties and supercharging CAR-T performance. This review highlights pivotal transcriptional factors, such as c-Jun and FOXO1, which enhance and sustain T cell effector function, diminishes exhaustion, and epigenetic regulators like TET2 and DNMT3A, whose knockout promotes memory T subsets formation. We explore their interconnections, downstream targets, biological impacts, and the potential application risks of certain candidates, providing a comprehensive theoretical framework for supercharging CAR-T therapies through transcriptional and epigenetic interventions.

Keywords: CAR-T cells; epigenetic modification; exhaustion and memory differentiation; transcriptional regulation in immunotherapy; tumor microenvironment.

Publication types

  • Review

MeSH terms

  • Animals
  • Cell Differentiation / genetics
  • DNA Methyltransferase 3A
  • Epigenesis, Genetic*
  • Forkhead Box Protein O1 / genetics
  • Forkhead Box Protein O1 / metabolism
  • Humans
  • Immunotherapy, Adoptive* / methods
  • Neoplasms / genetics
  • Neoplasms / therapy
  • Receptors, Chimeric Antigen / genetics
  • Receptors, Chimeric Antigen / immunology
  • Receptors, Chimeric Antigen / metabolism
  • T-Lymphocytes / immunology
  • Transcription Factors / genetics
  • Transcription Factors / metabolism
  • Transcription, Genetic

Substances

  • Receptors, Chimeric Antigen
  • Transcription Factors
  • DNA Methyltransferase 3A
  • Forkhead Box Protein O1