Among these, several obstacles affecting the function of CAR-T in the tumor microenvironment (TME) include hypoxia, high lactate levels, activation of the PD-1/PD-L1 axis, and accumulation of the extracellular matrix (ECM) (138, 140, 142, 145).Secondly, CAR-T therapy also faces limitations such as long treatment cycles, high costs, and the need for standardization, safety, and reliability (130). This evidence concerns the gene CD274 and neoplasm.