An Australian Narrative Review of Adoptive Cellular Therapies in Malignancy: Expanding Indications, Referral Pathways and Safety Beyond Specialist Centres
14 affiliations
- 1The Kinghorn Cancer Centre St Vincent's Hospital Sydney New South Wales Australia
- 2Garvan Institute of Medical Research Sydney New South Wales Australia
- 3School of Medicine and Health UNSW Sydney Sydney New South Wales Australia
- 4Department of Haematology St Vincent's Hospital Sydney New South Wales Australia
- 5St Vincent's Centre for Applied Medical Research Sydney New South Wales Australia
- 6Department of Neurology St Vincent's Hospital Sydney New South Wales Australia
- 7Department of Rheumatology St Vincent's Hospital Sydney New South Wales Australia
- 8Cancer Institute NSW Sydney New South Wales Australia
- 9School of Medicine and Public Health University of Newcastle Newcastle New South Wales Australia
- 10Melanoma Discovery Laboratory Harry Perkins Institute of Medical Research Perth Western Australia Australia
- 11School of Medicine University of Western Australia Perth Western Australia Australia
- 12Medical Oncology Department Royal Perth Hospital Perth Western Australia Australia
- 13Sir Peter MacCallum Department of Oncology The University of Melbourne Melbourne Victoria Australia
- 14Clinical Haematology Peter MacCallum Cancer Centre and Royal Melbourne Hospital Melbourne Victoria Australia
Abstract
Adoptive cellular therapies (ACT), including tumour‐infiltrating lymphocyte (TIL), T‐cell receptor‐engineered T (TCR‐T) cell and chimeric antigen receptor T‐cell (CAR‐T) therapies, represent an evolving class of immunotherapies with established efficacy in selected haematological malignancies and emerging applications in solid tumours. Additional platforms under investigation include virus‐specific T cells, tumour‐associated antigen‐specific T cells, natural killer (NK) cell therapies and dendritic cell‐based therapies. The therapeutic scope of ACT is expanding beyond oncology into autoimmune and fibrotic diseases, infectious diseases and inherited metabolic and immune disorders, highlighting the broad potential of cellular immunotherapy platforms. In solid tumours, efficacy remains limited by tumour antigen heterogeneity, immunosuppressive tumour micro‐environment and impaired immune cell trafficking and persistence. These barriers are driving development of next‐generation cellular products and combination strategies. Characteristic immune‐mediated toxicities, particularly cytokine release syndrome (CRS) and immune effector cell‐associated neurotoxicity syndrome (ICANS), remain important considerations. Although potentially severe, these toxicities are generally manageable with early recognition, multidisciplinary care and prompt specialist intervention. As ACT indications expand in Australia, clinician familiarity with indications, mechanisms of action and toxicity profiles is essential to support informed patient discussions, appropriate patient selection, timely referral and prompt toxicity recognition and management. Non‐oncology specialists have an important role in shared care, including patient identification, referral coordination, monitoring for delayed or late toxicities and provision of ongoing survivorship and supportive care. Achieving equitable national access to ACT will require streamlined health technology assessment processes, coordinated reimbursement and delivery funding models and structured referral networks with cross‐institutional collaboration to support the specialised infrastructure required for their delivery.
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BibTeX
@article{childs2026australian,
title = {{An Australian Narrative Review of Adoptive Cellular Therapies in Malignancy: Expanding Indications, Referral Pathways and Safety Beyond Specialist Centres}},
author = {Sarah Childs and David Ma and Anthony Rodrigues and Jennifer Massey and Rasha Cosman and Venessa Chin and Laila Girgis and James Lynam and Peter Lau and Barbara Withers and Anthony M. Joshua and Ben Tran and Jayesh Desai and Simon J. Harrison and John Moore and Jia Liu},
journal = {The Medical Journal of Australia},
year = {2026},
month = oct,
doi = {10.5694/mja2.70321},
url = {https://doi.org/10.5694/mja2.70321},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - An Australian Narrative Review of Adoptive Cellular Therapies in Malignancy: Expanding Indications, Referral Pathways and Safety Beyond Specialist Centres
AU - Sarah Childs
AU - David Ma
AU - Anthony Rodrigues
AU - Jennifer Massey
AU - Rasha Cosman
AU - Venessa Chin
AU - Laila Girgis
AU - James Lynam
AU - Peter Lau
AU - Barbara Withers
AU - Anthony M. Joshua
AU - Ben Tran
AU - Jayesh Desai
AU - Simon J. Harrison
AU - John Moore
AU - Jia Liu
PY - 2026
DA - 2026/10/27
JO - The Medical Journal of Australia
DO - 10.5694/mja2.70321
UR - https://doi.org/10.5694/mja2.70321
AB - Adoptive cellular therapies (ACT), including tumour‐infiltrating lymphocyte (TIL), T‐cell receptor‐engineered T (TCR‐T) cell and chimeric antigen receptor T‐cell (CAR‐T) therapies, represent an evolving class of immunotherapies with established efficacy in selected haematological malignancies and emerging applications in solid tumours. Additional platforms under investigation include virus‐specific T cells, tumour‐associated antigen‐specific T cells, natural killer (NK) cell therapies and dendritic cell‐based therapies. The therapeutic scope of ACT is expanding beyond oncology into autoimmune and fibrotic diseases, infectious diseases and inherited metabolic and immune disorders, highlighting the broad potential of cellular immunotherapy platforms. In solid tumours, efficacy remains limited by tumour antigen heterogeneity, immunosuppressive tumour micro‐environment and impaired immune cell trafficking and persistence. These barriers are driving development of next‐generation cellular products and combination strategies. Characteristic immune‐mediated toxicities, particularly cytokine release syndrome (CRS) and immune effector cell‐associated neurotoxicity syndrome (ICANS), remain important considerations. Although potentially severe, these toxicities are generally manageable with early recognition, multidisciplinary care and prompt specialist intervention. As ACT indications expand in Australia, clinician familiarity with indications, mechanisms of action and toxicity profiles is essential to support informed patient discussions, appropriate patient selection, timely referral and prompt toxicity recognition and management. Non‐oncology specialists have an important role in shared care, including patient identification, referral coordination, monitoring for delayed or late toxicities and provision of ongoing survivorship and supportive care. Achieving equitable national access to ACT will require streamlined health technology assessment processes, coordinated reimbursement and delivery funding models and structured referral networks with cross‐institutional collaboration to support the specialised infrastructure required for their delivery.
SN - 0025-729X
SN - 1326-5377
ER -