FIGURE 1 Schematic of CAR structure in relation to CD19
expressing tumor cells . CARs are composed of single-chain variable
fragment (shown here as FMC63) joined to an intracellular CD3 zeta
signaling domain. Tisagenlecleucel is a second-generation CAR construct
that incorporates a second additional co-stimulatory endodomain (4-1BB).
FIGURE 2 Diagram of CAR T cell manufacturing and treatment
process . The treatment process starts with leukapheresis of the
patient’s peripheral blood mononuclear cells, which is then frozen and
shipped to the appropriate manufacturing facility for ex-vivo
modifications. T cells are activated and expanded using
anti-CD3/anti-CD28 coated beads and expression of CAR is transduced
using lentiviral vector. Successfully manufactured products are shipped
back to the treating facility, where it is given intravenously back to
the patient.