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KEY POINTS * T lymphocytes transition through progressive stages of differentiation that are characterized by a stepwise loss of functional and therapeutic potential. * Subsets of mature T
cells exhibit the stem cell-like attributes of self-renewal, multipotency and the ability to undergo asymmetric division. * Evolutionarily conserved pathways regulating stemness are active
in T cells, including T memory stem cells, T helper 17 cells and interleukin-17 (IL-17)-producing CD8+ T cells. * Pharmacological and genetic induction of stem cell pathways can be used to
generate tumour-specific T cells with stem cell-like properties. * Reprogramming terminally differentiated tumour-reactive T cells to display naive or stem cell-like functionalities might be
obtained through the expression of transcription factors or microRNAs that are associated with naive or T memory stem cells. * Stem cell-like T cells possess enhanced capacities to engraft,
persist and mediate prolonged immune attack against tumour masses that are sustained by long-lived cancer stem cells. ABSTRACT Stem cells are defined by the ability to self-renew and to
generate differentiated progeny, qualities that are maintained by evolutionarily conserved pathways that can lead to cancer when deregulated. There is now evidence that these stem cell-like
attributes and signalling pathways are also shared among subsets of mature memory T lymphocytes. We discuss how using stem cell-like T cells can overcome the limitations of current adoptive
T cell therapies, including inefficient T cell engraftment, persistence and ability to mediate prolonged immune attack. Conferring stemness to antitumour T cells might unleash the full
potential of cellular therapies. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your
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our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS STEM-LIKE EXHAUSTED AND MEMORY CD8+ T CELLS IN CANCER Article 11 October 2023 CELLULAR NETWORKS CONTROLLING T CELL
PERSISTENCE IN ADOPTIVE CELL THERAPY Article 20 April 2021 T CELL DYSFUNCTION AND THERAPEUTIC INTERVENTION IN CANCER Article 18 July 2024 REFERENCES * Weissman, I. L. Stem cells: units of
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ACKNOWLEDGEMENTS This work was supported by the National Institutes of Health, Center for Regenerative Medicine (NIH-CRM) and by the Center for Cancer Research (CCR) by the US National
Cancer Institute (Bethesda, Maryland). The authors would like to thank M. Rao for helpful discussions about regenerative medicine. M. Bachinski copyedited the manuscript during construction.
J. Crompton, R. Roychoudhuri, P. Muranski, D. Palmer, Y. Ji, M. Sukumar, J. Pan, A. Leonardi, Z. Franco, Z. Yu and D. Clever provided a lively sounding board for concepts presented here. J.
C. Yang, U. S. Kammula, R. A. Morgan, S. A. Feldman, P. F. Robbins, R. M. Sherry, M. Parkhurst, M. Hughes and G. Phan made many valuable suggestions regarding the clinical translation of
the work described. The authors would especially like to thank our longtime stalwart ally in all of these efforts S. A. Rosenberg. AUTHOR INFORMATION Author notes * Luca Gattinoni and
Christopher A. Klebanoff: These authors contributed equally to this work. AUTHORS AND AFFILIATIONS * Center for Cancer Research, National Cancer Institute, National Institutes of Health,
Bethesda, 20892, Maryland, USA Luca Gattinoni, Christopher A. Klebanoff & Nicholas P. Restifo Authors * Luca Gattinoni View author publications You can also search for this author
inPubMed Google Scholar * Christopher A. Klebanoff View author publications You can also search for this author inPubMed Google Scholar * Nicholas P. Restifo View author publications You can
also search for this author inPubMed Google Scholar CORRESPONDING AUTHORS Correspondence to Luca Gattinoni or Nicholas P. Restifo. ETHICS DECLARATIONS COMPETING INTERESTS The authors
declare no competing financial interests. RELATED LINKS FURTHER INFORMATION Luca Gattinoni's homepage Nicholas P. Restifo's homepage GLOSSARY * Self-renewal A biological process by
which a cell gives rise to one or two daughter cells that have a developmental potential that is indistinguishable from that of the mother cell. * Multipotency The potential for a cell to
give rise to progeny with the capacity to form multiple, but not all possible, lineages. * Tumour-infiltrating lymphocytes (TILs). The heterogeneous population of T cells found in a tumour
bed. These cells are characterized by a diversity of phenotypes, antigen specificities, avidities and functional characteristics. They can be activated and expanded _ex vivo_ and re-infused
into a tumour-bearing host to mediate tumour regression. * Mass cytometry Also known as cytometry by time-of-flight (CyTOF). A platform that couples flow cytometry with mass spectrometry.
This technique enables the simultaneous evaluation of at least 45 simultaneous phenotypic and functional parameters on a single cell without the use of fluorescent agents or interference
from spectral overlap. * Senescence A biological process by which cells undergo growth arrest after extensive replication. * Homeostatic proliferation A process of activation and
proliferation of leukocytes in a lymphopaenic environment. T cell homeostatic proliferation is driven by T cell receptor interactions with self-peptide–MHC complexes and responsiveness to
homeostatic cytokines such as interleukin-7 (IL-7), IL-15 and possibly IL-21. * TCR excision circles (TRECs). Circular, stable extra-chromosomal DNA fragments that are generated during
recombination of variable (V), diversity (D) and joining regions (J) of the T cell receptor. TRECs do not replicate with cellular proliferation and are thus diluted with every cell division,
allowing the assessment of the replicative history of a T cell. * Asymmetric cell division A conserved mechanism by which a cell divides into daughter cells of unequal size and cytoplasmic
content, thus conferring differential developmental fates to progeny cells. * Telomere The segment at the end of chromosomal arms consisting of a series of repeated DNA sequences (TTAGGG in
all vertebrates) that regulates chromosomal replication at each cell division. * Stem cell niche A specialized microenvironment containing stem cells that supports their maintenance and
regulates their function. * Common γ-chain (γC). A signalling subunit common to the receptors for interleukin-2 (IL-2), IL-4, IL-7, IL-9, IL-15 and IL-21. * Exhaustion A state of T cell
dysfunction arising during reiterative antigen stimulations such as chronic infections and cancer. It is defined by poor effector function and proliferative response to antigenic stimuli,
expression of inhibitory receptors and a transcriptional state that is distinct from that of functional effector or memory T cells. * Autosomal-dominant hyper-IgE syndrome (AD-HIES). Also
known as Job's syndrome. A rare primary immunodeficiency characterized by recurrent skin abscesses, cyst-forming pneumonias and extreme increases of serum IgE levels. Most AD-HIES cases
are caused by dominant-negative mutations in _STAT3_. * Epigenetic modifications Heritable molecular alterations of the genome that do not involve changes to the nucleotide sequence that
regulates gene or microRNA expression. They include DNA methylation, histone modifications and nucleosome positioning. * Induced pluripotent stem (iPS) cells Pluripotent stem cells
artificially derived from non-pluripotent cells, such as an adult somatic cell by forced expression of specific genes or microRNAs. * Suicide genes Genes capable of selectively eliminating
the cells into which they have been transduced following the administration of a drug. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Gattinoni, L.,
Klebanoff, C. & Restifo, N. Paths to stemness: building the ultimate antitumour T cell. _Nat Rev Cancer_ 12, 671–684 (2012). https://doi.org/10.1038/nrc3322 Download citation *
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