Dual CAR-T cell therapy for glioblastoma: strategies to cure tumour diseases based on a mathematical model

The CAR-T cell immunotherapy entails the genetic reprogramming of T-lymphocytes, which then engage with cancer cells, triggering an anti-tumour immune response. While this treatment has gained approval for hematological cancers, addressing solid tumours presents new obstacles. Challenges include the heterogeneity of antigen expression within solid tumours, encompassing antigen-positive non-tumoural cells, the presence of immune inhibitory molecules, and the difficulty of CAR-T cell trafficking within the tumour microenvironment. In this article, we analytically study a generalisation of a mathematical model proposed by León-Triana et al. (Cancers 13(4):703, 2021a. https://doi.org/10.3390/cancers13040703, Commun Nonlinear Sci Numer Simul 94:105570). This model focuses on the dynamics of glioblastoma, the most aggressive brain tumour, and its response to CAR-T cell treatment. We study the basic properties of the model, the dynamics of the solutions of the model when the treatment is not sustained during the time, and finally we study analytically the model when the therapy is constant, periodic and/or impulsive. We derive sufficient conditions for global stability of tumour-free equilibrium, as well as necessary and sufficient conditions for local stability of the equilibrium obtaining conditions for an effective treatment. Finally, we perform different numerical simulations to find the strategies to keep the tumour under control. The obtained results are based on a combination of different analytical techniques in differential equations, dynamical systems and numerical simulations.