One of the most common misconceptions I still see is that CAR-T therapy is only relevant for B-cell leukemia.

Historically, that was largely true.

Most approved CAR-T therapies target CD19, which is expressed on B cells but not on T-cell ALL. That left researchers with a difficult problem: how to develop CAR-T against T-cell leukemia without causing the engineered T cells to attack one another.

CD7 emerged as a promising target because it's expressed on the majority of T-cell ALL cases. The challenge is that normal T cells also express CD7, leading to "fratricide."

Gene editing appears to be changing that.

Groups in both the UK and the US are developing CD7-directed CAR-T products by removing CD7 from the therapeutic T cells before infusion. One approach uses base editing (BE-CAR7), while another uses CRISPR-based engineering in an allogeneic product.

These therapies remain investigational, but the early clinical data suggest that CAR-T may eventually become a realistic option for some patients with relapsed or refractory T-cell ALL.

I'm interested to hear what others think.

Will CD7-directed CAR-T become the standard approach for T-ALL, or do you think other immunotherapies are more likely to dominate in the future?