The elderly population in China is growing increasingly, and elderly individuals are typically characterized by high incidence and mortality rates of cancer. In recent years, adoptive cellular immunotherapy has demonstrated reliable efficacy in cancer treatment. T cell receptor-engineered T (TCR-T) cell therapy, a form of adoptive cellular therapy, demonstrates considerable promise in the treatment of solid tumors. However, the current TCR-T cell-related technologies still face numerous challenges when confronted with issues such as the decline in T cell efficacy and diversity, as well as changes in the tumor microenvironment in elderly cancer patients. Meanwhile, TCR-T cell therapy itself is plagued by the significant challenge of off-target cross-reactivity. To tackle these challenges and develop effective treatment regimens for elderly cancer patients, this review focuses on improving the precision of TCR-T cell therapy and introduces a series of emerging TCR-T-related technologies targeting cancer-testis antigens from various aspects, aiming to offer new strategies for the development of TCR-T cell therapy.