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Since tisagenlecleucel (Kymriah) was approved by the FDA in 2017, five more chimeric antigen receptor (CAR)-T cell therapies have gained approval, the last one of which, ciltacabtagene autoleucel (Carvykti), was approved in February 2022. The cell therapy field is still expanding and evolving beyond the early successes in haematological cancers. Novel technologies using other immune and stromal cell types are being investigated, and the list of targets in the global R&D pipeline keeps growing. Despite this pipeline expansion, the field also faces challenges — such as effective targeting of solid tumours, manufacturing complexities and barriers to clinical implementation — that affect the broad uptake of cell therapies into clinical practice. In this update, we provide an in-depth analysis of the current cell therapy landscape, including the development pipeline and clinical trials. We have also analysed real-world data to describe the current use of cell therapies in clinical practice and some of the challenges to their implementation.