Longevity & Aging

In Vivo CAR-T Engineering Could Make Cancer Cell Therapy Cheaper, Faster and More Accessible

Approved CAR-T therapies are made outside the body from each patient's own T cells. This is slow, costly and logistically hard, and it requires lymphodepleting chemotherapy. This review examines in vivo CAR-T engineering, where a vector injected into the patient reprograms T cells inside the body. The authors compare viral platforms (lentiviruses, γ-retroviruses, AAV, viral-like particles) and non-viral platforms (lipid nanoparticles, polymers). They focus on how surface engineering, envelope protein choice and targeting ligands steer vectors to T cells. Early preclinical data show selective T cell transduction and tumor or B cell clearance in humanized mice. First-in-human reports now exist in myeloma and lupus. Key hurdles remain: vector stability, T cell specificity, immunogenicity, and unproven cost claims.