Evidence map›Paper›PMID 42270901›Full record

ArticleNature cancer2026

Iron-mediated ferroptosis impairs CAR-T cell function and antitumor efficacy.

Delin Kong, Tingting Yang, Mengyu Zhao, Lin Yang, Ruirui Jing, Youqin Feng, Shaohui Shi, Zhouning Lin, Shi Han, Cong Wei and 28 more

Abstract read
PubMed Publisher
In one paragraph

Article in Nature cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

38 authors.

Delin Kong *Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Tingting Yang *Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Mengyu Zhao *Department of Hematology, Zhejiang Cancer Hospital, Hangzhou, China.
Lin Yang *Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Ruirui Jing *Department of Hematology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Youqin FengBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Shaohui ShiLiangzhu Laboratory, Zhejiang University, Hangzhou, China.
Zhouning LinBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Shi HanBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Cong WeiBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Rongrong ChenBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Qiqi ZhangBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Jiazhen CuiBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Tianning GuBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.ORCID http://orcid.org/0000-0003-1550-1011
Xiujian WangBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Xia LiBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.ORCID http://orcid.org/0000-0002-1443-3996
Ye MengBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Xiaolin YuanDepartment of Hematology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Mingming ZhangBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Linghui ZhouBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Houli ZhaoBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Ruimin HongBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Simao HuangBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Mi ShaoBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Xiaohui SiBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yingli HanBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Shufen WangInstitute of Hematology, Zhejiang University, Hangzhou, China.
Xiangjun ZengBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Dawei HuoBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Meng ZhangBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Kejia HuBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Zenan CenBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Haiqiong ZhengBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Guoqing WeiBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Dongrui WangBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. dongrui-wang@zju.edu.cn.ORCID http://orcid.org/0000-0002-0859-7281
Yongxian HuBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. 1313016@zju.edu.cn.
Pengxu QianLiangzhu Laboratory, Zhejiang University, Hangzhou, China. axu@zju.edu.cn.ORCID http://orcid.org/0000-0001-5636-6704
He HuangBone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. huanghe@zju.edu.cn.ORCID http://orcid.org/0000-0002-2723-1621

Funding

National Natural Science Foundation of China (National Science Foundation of China) 82130003, 92268117, 82161138028 and 82000149National Natural Science Foundation of China (National Science Foundation of China) 82200250National Natural Science Foundation of China (National Science Foundation of China) 82270234National Natural Science Foundation of China (National Science Foundation of China) 82270235National Natural Science Foundation of China (National Science Foundation of China) 82341205, 82341206National Natural Science Foundation of China (National Science Foundation of China) 82570196, 82200162Science and Technology Department of Zhejiang Province 2021C03010Science and Technology Department of Zhejiang Province 2025C02075
6 · The paper itself

Abstract

Long-term persistence of chimeric antigen receptor (CAR)-T cells is essential for durable therapeutic efficacy but the mechanisms underlying CAR-T cell dysfunction remain unclear. On the basis of integrated analyses of clinical samples from participants with multiple myeloma and acute lymphoblastic leukemia treated with CAR-T cells, we show that rapid expansion of CAR-T cells after infusion is followed by a 'diminution' phase characterized by ferroptosis-associated features and elevated serum iron levels. In preclinical cancer models in female mice and ex vivo culture systems, excess intracellular iron impaired CAR-T cell function. Mechanistically, iron promoted ferroptosis by increasing mitochondrial reactive oxygen species and lipid peroxidation, in part through acyl-CoA synthetase long-chain family member 4 (ACSL4)-associated lipid remodeling. Targeting ferroptosis, particularly through genetic ablation of ACSL4 in CAR-T cells, substantially enhanced antitumor efficacy. Together, these findings identify iron-driven ferroptosis as a determinant of CAR-T cell dysfunction and a targetable barrier to durable CAR-T efficacy.

Indexed as

FerroptosisImmunotherapy, AdoptiveIronMultiple MyelomaPrecursor Cell Lymphoblastic Leukemia-LymphomaReceptors, Chimeric AntigenAnimalsCell Line, TumorCoenzyme A LigasesFemaleHumansLipid PeroxidationLong-Chain-Fatty-Acid-CoA LigaseMiceReactive Oxygen SpeciesXenograft Model Antitumor AssaysAcsl4 protein, mouseCoenzyme A LigasesIronLong-Chain-Fatty-Acid-CoA LigaseReactive Oxygen SpeciesReceptors, Chimeric Antigen

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.