CAR-NK cell immunotherapy: Development and challenges toward an off-the-shelf product

Abstract Chimeric antigen receptor (CAR)-T cells have emerged as a novel immunotherapy that has redefined cancer treatment. Despite its clinical success, this therapy has many limitations that have redirected scientist to investigate other immune cells for CAR therapy. Hence, natural killer (NK) cells have drawn increased attention as being superior to CAR-T cells due to the advantages they offer such as (1) better safety profile and less life-threatening complications such as cytokine release syndrome and neurotoxicity, (2) reduced cost of manufacturing per dose, (3) maintaining cytotoxic activity independent of CAR, and (4) high potential for an off-the-shelf product. In this chapter, we focus on the sources, development, advantages, and challenges of CAR-NK cell immunotherapy and its future promise as a novel immunotherapy in cancer treatment.