23 September 2019

Radiation treatment could benefit non-Hodgkin’s lymphoma patients undergoing CAR-T therapy, researchers have reported at a medical conference.

The study was led by a team at the University of Pennsylvania, USA. Dr John Plastaras and colleagues examined the medical records of 31 patients who had received CAR-T cell therapy, including commercially available tisagenlecleucel (Kymriah) and axicabtagene ciloleucel (Yescarta).

The patients fell into three groups. One group had been given radiation within 30 days before reinfusion of CAR-T cells; another had had radiotherapy at some point during their cancer treatment, but not specifically as a bridging therapy before CAR-T infusion; and the final group had received no radiation therapy.

Among the patients in the first group, who received radiation as a bridging therapy, none showed serious cytokine release syndrome or neurotoxicity, side effects often associated with CAR-T cell therapy.

In the group who had previously received radiation, only one experienced a serious side effect. However, in the 19 patients who received no radiotherapy, five experienced a serious side effect.

Dr Plastaras said: “Our findings suggest that not only does radiation not interfere with the efficacy of CAR-T, it may even carry a benefit for non-Hodgkin’s lymphoma patients.”

Researcher Dr Michael LaRiviere added: “These data are consistent with other reports of patients treated with radiation prior to CAR-T therapy, meaning we are starting to see a growing amount of evidence that adding radiation to CAR-T therapy is safe and may have potential benefits.”

The research team plan to validate the findings in future clinical trials. Full details were presented by Dr LaRiviere at the American Society for Radiation Oncology Annual Meeting in Chicago, USA.

Source: LaRiviere, M.J., Wright, C.M., Arscott, W.T., Miller, D., Weber, E., Landsburg, D.J., Svoboda, J., Nasta, S.D., Gerson, J.N., Chong, E.A., Schuster, S., Maity, A., Plastaras, J.P. (2019) “Induction Radiation Prior to Commercial Chimeric Antigen Receptor T-Cell Therapy for Relapsed/Refractory Non-Hodgkin Lymphoma”, presented at American Society for Radiation Oncology Annual Meeting 2019.

Abstract available at https://doi.org/10.1016/j.ijrobp.2019.06.514


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