“…CAR engineering efforts thus far have revealed several design parameters that influence CAR-T cell function (Chang and Chen, 2017;Hong et al, 2020). These include co-stimulatory domains that booster T-cell activation upon antigen stimulation (Omer et al, 2018;Wijewarnasuriya et al, 2020;Zhao et al, 2015), extracellular domains that provide structural support for optimal T-cell/target-cell conjugation (Hudecek et al, 2013;Srivastava and Riddell, 2015), binding affinity between the CAR and the targeted antigen (Drent et al, 2019;Liu et al, 2015), as well as CAR-independent parameters such as antigen expression level on target cells (Majzner et al, 2020;Watanabe et al, 2015). However, these parameters cannot fully explain the difference between the CD19 CAR and other constructs such as CD20 CARs, which have similarly high binding affinities, contain the same co-stimulatory domains, and bind an antigen that is also highly expressed on the same type of tumor cells as targeted by the CD19 CAR.…”