Chimeric antigen receptor-natural killer
DOI:
https://doi.org/10.46765/2675-374X.2025v7n1e335Keywords:
Natural killer, CAR-NK, Cell therapyAbstract
Chimeric antigen receptor (CAR) technology has transformed adoptive cell therapy, particularly through the success of CAR-T cells in hematologic malignancies. However, challenges such as toxicity, complex manufacturing, and high costs have encouraged the exploration of alternative immune cell platforms. Natural killer (NK) cells represent a promising approach due to their intrinsic cytotoxic activity, major histocompatibility complex-independent tumor recognition, and lower risk of severe immune-related toxicities. CAR-NK cells combine CAR-mediated antigen targeting with the natural antitumor functions of NK cells, supporting the development of safer and potentially “off-the-shelf” cellular therapies. This chapter reviews the biological rationale of CAR-NK cells, current gene engineering strategies, and the evolving clinical landscape, highlighting their potential in hematologic malignancies, solid tumors, and autoimmune diseases.
References
1. Zhang F, Soleimani Samarkhazan H, Pooraskari Z, Bayani A. Beyond CAR-T: engineered NK cell therapies (CAR-NK, NKCEs) in next-generation cancer immunotherapy. Semin Immunol. 2025;67:101923. https://doi.org/10.1016/j.critrevonc.2025.104912
2. Marin D, Li Y, Basar R, Rafei H, Daher M, Dou J, et al. Safety, efficacy and determinants of response of allogeneic CD19-specific CAR-NK cells in CD19+ B-cell tumors: a phase 1/2 trial. Nat Med. 2024;30: 772-784. https://doi.org/10.1038/s41591-023-02785-8
3. Rezvani K, Rouce RH, Liu E, Shpall E. Engineering natural killer cells for cancer immunotherapy. Mol Ther. 2017;25:1769-1781. https://doi.org/10.1016/j.ymthe.2017.06.012
4. Wu X, Matosevic S. Gene-edited and CAR-NK cells: opportunities and challenges with engineering NK cells for immunotherapy. Mol Ther Oncolytics. 2022;27:224-238. https://doi.org/10.1016/j.omto.2022.10.011
5. McErlean EM, McCarthy HO. Non-viral approaches in CAR-NK cell engineering: connecting natural killer cell biology and gene delivery. J Nanobiotechnology. 2024;22:552. https://doi.org/10.1186/s12951-024-02746-4
6. ClinicalTrials.gov. CAR-NK cells clinical trials database [Internet]. Available from: https://clinicaltrials.gov/search?intr=CAR-NK%20cells&viewType=Card&aggFilters=status:rec&page=1. Accessed 2026 Mar 4.
7. Liu E, Marin D, Banerjee P, et al. Use of CAR-transduced natural killer cells in CD19-positive lymphoid tumors. N Engl J Med. 2020;382:545-553. https://doi.org/10.1056/NEJMoa1910607
8. Cheever A, Townsend M, O’Neill K. Tumor microenvironment immunosuppression: a roadblock to CAR T-cell advancement in solid tumors. Cells. 2022;11:3626. https://doi.org/10.3390/cells11223626
9. Melaiu O, Lucarini V, Cifaldi L, Fruci D. Influence of the tumor microenvironment on NK cell function in solid tumors. Front Immunol. 2020;10:3038. https://doi.org/10.3389/fimmu.2019.03038
10. Duan S, Guo W, Xu Z, et al. Natural killer group 2D receptor and its ligands in cancer immune escape. Mol Cancer. 2019;18:29. https://doi.org/10.1186/s12943-019-0956-8
11. Jørgensen LV, Christensen EB, Barnkob MB, Barington T. The clinical landscape of CAR NK cells. Exp Hematol Oncol. 2025;14(1):46. https://doi.org/10.1186/s40164-025-00633-8
12. Meng H, Sun X, Song Y, Zhang J, Wang Z, Liu Y, et al. La/SSB chimeric autoantibody receptor-modified NK92MI cells for targeted therapy of autoimmune disease. Clin Immunol. 2018;192:40-49. https://doi.org/10.1016/j.clim.2018.04.006
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Larissa Cardoso Zanetti, Raquel de Melo Alves Paiva, Lucila Nassif Kerbauy

This work is licensed under a Creative Commons Attribution 4.0 International License.
