Early experience using salvage radiotherapy for relapsed/refractory non-Hodgkin lymphomas after CD19 chimeric antigen receptor (CAR) T cell therapy

Br J Haematol. 2020 Jul;190(1):45-51. doi: 10.1111/bjh.16541. Epub 2020 Mar 5.

Abstract

Radiotherapy is potentially an important salvage strategy post-chimeric antigen receptor T cell therapy (CART), but limited data exist. We reviewed 14 patients treated with salvage radiation post-CART progression (SRT). Most received SRT for first post-CART relapse (71%) to sites previously PET-avid pre-CART (79%). Median overall survival (OS) post-SRT was 10 months. Post-SRT, six localized relapses achieved 100% response (3 = complete, 3 = partial), with improved freedom from subsequent relapse (P = 0·001) and OS (P = 0·004) compared to advanced stage relapses. Three were bridged to allogeneic transplantation; at analysis, all were alive/NED. SRT has diverse utility and can integrate with novel agents or transplantation to attempt durable remissions.

Keywords: CAR T cells; chimeric antigen receptor T cells; diffuse large B cell lymphoma; radiotherapy; relapsed/refractory; salvage therapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antigens, CD19
  • Female
  • Humans
  • Lymphoma, Non-Hodgkin / radiotherapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Receptors, Chimeric Antigen / therapeutic use*
  • Salvage Therapy / methods*
  • Young Adult

Substances

  • Antigens, CD19
  • Receptors, Chimeric Antigen