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Peer-reviewedCC BY 4.0Frontiers in Immunology

Clinical development landscape of CAR/TCR-engineered cellular therapies in musculoskeletal sarcomas: a TrialTrove-based registry analysis

5 affiliations
  1. 1Knee Preservation Center, The Affiliated Hospital of Qingdao University
  2. 2Suzhou Stomatological Hospital
  3. 3The Second School of Medicine, Wenzhou Medical University
  4. 4School of Laboratory Medicine and Life Sciences, Wenzhou Medical University
  5. 5Renji College of Wenzhou Medical University

Abstract

Background: CAR/TCR-engineered cellular therapies are increasingly investigated in musculoskeletal sarcomas, but the clinical development portfolio spans heterogeneous histologies, platforms, antigens, and basket protocols. We mapped the TrialTrove-derived landscape while explicitly separating engineered-receptor products from other cell-based immunotherapies.

Methods: TrialTrove clinical trial data were retrieved on 10 June 2026 and constituted the sole data source. Candidate records were identified using prespecified musculoskeletal-sarcoma disease terms and CAR/TCR-engineered-cell product terms. Two investigators independently assessed eligibility and assigned standardized classifications, with disagreements adjudicated by a third investigator. Potential duplicate representations were evaluated using TrialTrove, NCT, and normalized secondary identifiers plus study-level characteristics. We summarized temporal, geographic, phase, status, sponsor, protocol-planned enrollment, platform, target, disease-scope, co-intervention, concentration, and field-availability characteristics. Broader solid-tumor records with explicit sarcoma eligibility were reported separately, the export did not permit consistent determination of actual sarcoma enrollment or a dedicated sarcoma cohort.

Results: Of 140 identified records, 121 were eligible: 38 (31.4%) were sarcoma-specific and 83 (68.6%) were broader solid-tumour records with explicit sarcoma eligibility. Among 110 records with a start year, 63 (57.3%) began during 2021-2026. Phase I or I/II accounted for 108/121 records (89.3%), and median protocol-planned enrollment was 24 participants (IQR 15-49, n=103). The United States and China contributed 55.2% of 163 trial-country links. TCR-T and CAR-T accounted for 60 (49.6%) and 52 (43.0%) records, respectively. NY-ESO-1 contributed 45/125 trial-target links (36.0%), after excluding 12 Unspecified reporting links, the three most frequent specified antigens contributed 66/113 specified-antigen links (58.4%).

Conclusions: Engineered cellular-therapy development in musculoskeletal sarcomas has accelerated but remains predominantly early phase, geographically and antigenically concentrated, and represented largely by broader solid-tumour protocols that list sarcoma eligibility. Prespecified sarcoma strata, dedicated and independently analyzable cohorts, biomarker enrichment, harmonized outcomes, and transparent adjunct-strategy reporting should strengthen future evidence generation. This TrialTrove-based record analysis does not establish actual sarcoma enrollment in basket protocols, comparative efficacy, clinical superiority of a platform or antigen, or exhaustive global coverage.

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BibTeX
@article{jia2026clinical,
  title = {{Clinical development landscape of CAR/TCR-engineered cellular therapies in musculoskeletal sarcomas: a TrialTrove-based registry analysis}},
  author = {Xiaodong Jia and Qingyu Chen and Yaoyi Wang and Yemeng He and Jinhang Wang and Mingyue Yan},
  journal = {Frontiers in Immunology},
  year = {2026},
  month = oct,
  doi = {10.3389/fimmu.2026.1939952},
  url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1939952/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Clinical development landscape of CAR/TCR-engineered cellular therapies in musculoskeletal sarcomas: a TrialTrove-based registry analysis
AU  - Xiaodong Jia
AU  - Qingyu Chen
AU  - Yaoyi Wang
AU  - Yemeng He
AU  - Jinhang Wang
AU  - Mingyue Yan
PY  - 2026
DA  - 2026/10/28
JO  - Frontiers in Immunology
DO  - 10.3389/fimmu.2026.1939952
UR  - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1939952/full
AB  - Background: CAR/TCR-engineered cellular therapies are increasingly investigated in musculoskeletal sarcomas, but the clinical development portfolio spans heterogeneous histologies, platforms, antigens, and basket protocols. We mapped the TrialTrove-derived landscape while explicitly separating engineered-receptor products from other cell-based immunotherapies.  Methods: TrialTrove clinical trial data were retrieved on 10 June 2026 and constituted the sole data source. Candidate records were identified using prespecified musculoskeletal-sarcoma disease terms and CAR/TCR-engineered-cell product terms. Two investigators independently assessed eligibility and assigned standardized classifications, with disagreements adjudicated by a third investigator. Potential duplicate representations were evaluated using TrialTrove, NCT, and normalized secondary identifiers plus study-level characteristics. We summarized temporal, geographic, phase, status, sponsor, protocol-planned enrollment, platform, target, disease-scope, co-intervention, concentration, and field-availability characteristics. Broader solid-tumor records with explicit sarcoma eligibility were reported separately, the export did not permit consistent determination of actual sarcoma enrollment or a dedicated sarcoma cohort.  Results: Of 140 identified records, 121 were eligible: 38 (31.4%) were sarcoma-specific and 83 (68.6%) were broader solid-tumour records with explicit sarcoma eligibility. Among 110 records with a start year, 63 (57.3%) began during 2021-2026. Phase I or I/II accounted for 108/121 records (89.3%), and median protocol-planned enrollment was 24 participants (IQR 15-49, n=103). The United States and China contributed 55.2% of 163 trial-country links. TCR-T and CAR-T accounted for 60 (49.6%) and 52 (43.0%) records, respectively. NY-ESO-1 contributed 45/125 trial-target links (36.0%), after excluding 12 Unspecified reporting links, the three most frequent specified antigens contributed 66/113 specified-antigen links (58.4%).  Conclusions: Engineered cellular-therapy development in musculoskeletal sarcomas has accelerated but remains predominantly early phase, geographically and antigenically concentrated, and represented largely by broader solid-tumour protocols that list sarcoma eligibility. Prespecified sarcoma strata, dedicated and independently analyzable cohorts, biomarker enrichment, harmonized outcomes, and transparent adjunct-strategy reporting should strengthen future evidence generation. This TrialTrove-based record analysis does not establish actual sarcoma enrollment in basket protocols, comparative efficacy, clinical superiority of a platform or antigen, or exhaustive global coverage.
SN  - 1664-3224
ER  -