Adaptive, closed-loop control of cellular behavior is essential for next-generation therapies, yet most current treatments operate in an open-loop manner and lack robustness to patient variability and disease dynamics. Here, we establish a control-theoretic platform for rational engineering of closed-loop cell-based therapies that achieve precise and robust regulation. First, we introduce multi-dimensional nullgram profiling, a high-throughput approach that enables quantitative prediction and design of advanced genetic controllers in human cells across circuit topologies and parameter regimes in a single experiment. To evaluate dynamic therapeutic behavior, we next develop Cyberpatient-in-the-loop, an optogenetic digital twin platform that interfaces engineered mammalian cells with computational disease models, enabling systematic testing of closed-loop performance under realistic perturbations. Finally, we leverage these approaches to implement integral feedback cell therapies that sense inflammatory signals and autonomously regulate cytokine levels in primary immune cell cultures. Together, these results establish a general paradigm for engineering cell-based control systems and provide a foundation for next-generation cell therapies.