在免疫疗法中，利用基因改造的T细胞表达嵌合抗原受体（CAR）来治疗癌症。自体淋巴细胞从患者身体中提取出来，进行基因改造以获得CAR-T细胞，然后再引入患者体内来攻击癌细胞。该疗法在CD19阳性白血病和淋巴瘤领域取得了成功，已获批用于非何杰金淋巴瘤、急性淋巴细胞性白血病和多发性骨髓瘤的治疗。CAR是一种将抗体特异性与T细胞细胞毒性相结合的蛋白质。与该疗法相关的最常见的毒副反应通过临床前测试无法预测，包括细胞因子释放综合征、神经毒性和细胞减少症。这些毒副反应通常是可逆的。该领域面临的主要挑战之一是昂贵的经济成本，因此寻找降低成本的方法必须是首要任务。此外，其他需要克服的挑战包括不是所有患者都能获得该产品以及开始治疗的等待时间过长的情况。本综述的目的是介绍CAR-T细胞的结构发展、迄今为止获批的治疗方案、相关毒副反应以及它们作为免疫疗法的优点和局限性。

In immunotherapy with T cells genetically modified to express chimeric antigen receptors (CARs), autologous lymphocytes are extracted from the patient, genetically modified to obtain CAR-T cells, and reintroduced into the patient to attack cancer cells. The success of this therapy has been achieved in the area of CD19-positive leukemias and lymphomas, being approved for the treatment of non-Hodgkin's lymphomas, acute lymphoblastic leukemia, and multiple myeloma. CARs are proteins that combine antibody specificity with T-cell cytotoxicity. The most common toxicities associated with therapy were not predicted by preclinical testing and include cytokine release syndrome, neurotoxicity, and cytopenias. These toxicities are usually reversible. One of the main challenges facing the field is the high economic cost that therapy entails, so the search for ways to reduce this cost must be a priority. In addition, other challenges to overcome include the situation that not all patients are supplied with the product and the existence of long waiting times for the start of therapy. The aim of this review is to present the development of the structure of CAR-T cells, the therapies approved to date, the toxicity associated with them, and the advantages and limitations that they present as immunotherapy.