On-demand GLUT3 expression augments CAR T cell metabolic fitness and antitumor efficacy in preclinical models of glioblastoma

Junya Yamaguchi , Keisuke Watanabe, Akihiro Nakamura, Nina Yi-Tzu Lin, Sachi Maeda, Daisuke Sugiyama, Shinichiro Kato, Akihito Nagata, Hitomi Nishinakamura, Kota Itahashi, Shohei Koyama, Hiroyuki Mizoguchi, Yukihiro Shiraki, Atsushi Enomoto, Fumiharu Ohka, Kazuya Motomura, Yuichiro Tsukada, Masaaki Ito, Yuka Maeda, Ryuzo Ueda, Atsushi Natsume, Ryuta Saito, Hiroyoshi Nishikawa

Sci. Transl. Med. | 2026 | 18 | eadu3532

The clinical success of chimeric antigen receptor T cell (CAR T cell) therapy in hematologic malignancies has prompted its application for refractory solid tumors, including glioblastoma (GBM). However, CAR T cell trials against solid tumors have failed to show clinical efficacy thus far. Here, we show that the dysfunction of CAR T cells in GBM is attributed, at least, in part, to glucose deficiency in the tumor microenvironment (TME) driven by the substantial consumption of glucose by cancer cells. Engineering CAR T cells to continuously express glucose transporter 3 (GLUT3), a high-affinity glucose transporter, restored their cytokine production and killing activity. However, although CAR T cells with stable GLUT3 expression induced tumor reduction in a preclinical GBM model, their overactivation led to adverse events and mouse death. In contrast, on-demand GLUT3-expressing CAR T cells, in which GLUT3 transcription was driven by the nuclear translocation of nuclear factor of activated T cells (NFAT) as a consequence of target antigen stimulation, exhibited enhanced metabolic fitness and increased antitumor efficacy, leading to long-lasting tumor control in intracranial human GBM cell xenograft models while preventing adverse events. We propose that on-demand enhancement of metabolic fitness, such as at the time of exposure to tumor antigens, is a concept for boosting the antitumor efficacy of CAR T cells against solid tumors.