Adoptive T cell transfer therapies. Tumor-specific T cells can be isolated from tumors or generated by genetic engineering of peripheral T cells. To eliminate the tumor, infused therapeutic T cells need to reach cancer cells, proliferate, and survive in a hostile tumor microenvironment. Research approaches to overcome these challenges while preventing toxicity and ensuring access to every patient are exemplified. Abbreviations: CAR, chimeric antigen receptor; TCR, T cell receptor; TIL, tumor-infiltrating lymphocyte; TRUCK, T cell redirected for universal cytokine-mediated killing; UCAR-T, universal CAR-T cell; UTCR-T, universal TCR-T cell.