CAR T-cel therapy; Is there a role for radiotherapy?
,
The Netherlands
SP-0028
Abstract
CAR T-cel therapy; Is there a role for radiotherapy?
1University Medical Center Groningen, Radiation Oncology, Groningen, The Netherlands
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Abstract Text
Patients with Large B-cell lymphoma (LBCL) who have refractory or relapse disease after two lines of systemic therapy (ST) have a very poor prognosis. For these patients anti-CD19 chimeric antigen receptor T-cell (CART) therapy has emerged as a potential curative treatment regime as approximately half of the patients achieve long-term disease-free survival. CAR T-cells are generated from autologous T-cells, collected through an apheresis procedure. The logistics and production are time consuming and may take up to 4-6 weeks.
Many patients in which CART therapy (CARTT) is indicated have symptomatic and progressive disease that requires some form of treatment to support them during the production period. Bridging therapy, referred to therapy administered after apheresis until CART infusion may be indicated. Selection of bridging treatment type is based on prior treatment, tumor load and symptoms. Early reports on radiotherapy as a bridging strategy have shown feasibility, safety and effectivity in this heavily pre-treated patient population. Patient numbers are limited and still little is known about the optimal dose, target definition and timing. Besides used as a bridging strategy, radiotherapy might play a role in optimizing CAR T-cell response, due to the immune modulating effect on both tumour cells and micro-environment.