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# On In Vivo CAR-T
- URL: https://www.riamshammaamd.com/articles/on-in-vivo-car-t/
- Published: 2026-09-24T16:02:58.000Z
- Updated: 2026-09-24T17:18:42.000Z
- Description: In Vivo CAR-T may allow us to treat cancer without the $350k cost per dose.
- Author: Riam Shammaa
- Tags: Cancer Cell Therapy

CAR-T has produced remarkable results in blood cancers, but it remains one of the most complicated and expensive therapies we have. We collect a patient's T cells, genetically engineer and expand them in a specialized facility, and then return them weeks later. It works, but with many challenges, it is difficult to manufacture, expensive and hard to scale.

But now the next generation is just the virus! Injecting the virus that carries the CAR into the patient's own T cells in their bodies.

That idea suddenly became much more interesting after the 2025 American Society of Hematology meeting.

In the first-in-human inMMyCAR study, patients with relapsed/refractory multiple myeloma received KLN-1010, an intravenous vector designed to generate BCMA-targeting CAR-T cells directly inside the body. No cell collection. No individualized manufacturing. Importantly, lymphodepleting chemotherapy was not required!

The early results were impressive. All three patients treated at the time of the presentation achieved a very good partial response. CAR-T cells expanded inside the patients, reaching 22–72% of circulating T cells, and cells with a memory phenotype remained detectable in blood and bone marrow for at least three months.

Three patients is obviously far too early to draw conclusions about efficacy or long-term safety. There are still important questions about targeting, off-target transduction, durability and control of the engineered cells.

But the direction is becoming difficult to ignore.

If these results hold in larger trials, the next generation of CAR-T may not require us to manufacture a personalized cell product for every patient. And potentially significantly cut the costs.

**We may simply teach the patient's own immune cells what to do—inside the body.**