| Title: |
Outcomes with bridging radiation therapy prior to chimeric antigen receptor T-cell therapy in patients with aggressive large B-cell lymphomas |
| Authors: |
Manzar, Gohar S.; Pinnix, Chelsea C.; Dudzinski, Stephanie O.; Marqueen, Kathryn E.; Cha, Elaine E.; Nasr, Lewis F.; Yoder, Alison K.; Rooney, Michael K.; Strati, Paolo; Ahmed, Sairah; Nze, Chijioke; Nair, Ranjit; Fayad, Luis E.; Wang, Michael; Nastoupil, Loretta J.; Westin, Jason R.; Flowers, Christopher R.; Neelapu, Sattva S.; Gunther, Jillian R.; Dabaja, Bouthaina S.; Wu, Susan Y.; Fang, Penny Q. |
| Source: |
Frontiers in Immunology ; volume 16 ; ISSN 1664-3224 |
| Publisher Information: |
Frontiers Media SA |
| Publication Year: |
2025 |
| Collection: |
Frontiers (Publisher - via CrossRef) |
| Description: |
Background Select patients with relapsed/refractory aggressive B cell lymphoma may benefit from bridging radiation (bRT) prior to anti-CD19-directed chimeric antigen receptor T cell therapy (CAR-T). Here, we examined patient and treatment factors associated with outcomes and patterns of failure after bRT and CAR-T. Methods We retrospectively reviewed adults with diffuse large B-cell lymphoma (DLBCL) who received bRT prior to axicabtagene ciloleucel, tisagenlecleucel, or lisocabtagene maraleucel between 11/2017-4/2023. Clinical/treatment characteristics, response, and toxicity were extracted. Survival was modeled using Kaplan-Meier or Cox regression models for events distributed over time, or binary logistic regression for disease response. Fisher’s Exact Test or Mann-Whitney U methods were used. Results Of 51 patients, 25.5% had bulky disease and 64.7% had Stage III/IV disease at the time of RT. Comprehensive bRT alone to all disease sites was delivered to 51% of patients, and 29.4% were additionally bridged with systemic therapy. Median follow-up was 10.3 months (95% CI: 7.7-16.4). Overall response rate (ORR) was 82.4% at 30 days post-CAR-T infusion. Median overall survival (OS) was 22.1 months (6.6-not reached) and the median progression-free survival (PFS) was 7.4 months (5.5-30). OS/PFS were 80% (66-99)/78% (64-87) at 1-year, and 59% (44-71)/54% (40-67) at 2-years, respectively. Comprehensive RT to all sites of disease correlated with improved PFS and OS, p ≤ 0.04. Additionally, ECOG ≥2 and Stage III/IV disease predicted poor OS ( p ≤ 0.02). Disease bulk, IPI ≥3, and non-GCB histology were poor predictors for disease-specific survival (DSS), p |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| DOI: |
10.3389/fimmu.2025.1517348 |
| DOI: |
10.3389/fimmu.2025.1517348/full |
| Availability: |
https://doi.org/10.3389/fimmu.2025.1517348; https://www.frontiersin.org/articles/10.3389/fimmu.2025.1517348/full |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.D80EC3DB |
| Database: |
BASE |