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嵌合抗原受体（CAR）T 细胞治疗后复发/难治性非霍奇金淋巴瘤采用挽救性放疗的早期经验。

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

机构信息

Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Center for Cell Engineering and Immunology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

出版信息

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

DOI:10.1111/bjh.16541
PMID:32135029
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7329607/
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.

摘要

放疗是嵌合抗原受体 T 细胞疗法（CART）后一种有潜力的重要挽救策略，但相关数据有限。我们回顾了 14 例接受 CART 进展后挽救性放疗（SRT）治疗的患者。大多数患者因首次 CART 复发（71%）至先前 CART 前 PET 阳性部位而接受 SRT（79%）。SRT 后中位总生存期（OS）为 10 个月。SRT 后，6 例局限性复发达到 100%缓解（3 例完全缓解，3 例部分缓解），与晚期复发相比，无后续复发（P=0·001）和 OS（P=0·004）均得到改善。3 例患者接受异基因移植桥接治疗；在分析时，所有患者均存活/无疾病。SRT 具有多种用途，可与新的药物或移植相结合，以尝试持久缓解。

相似文献

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引用本文的文献

[1]
CAR T-Cell Therapies for Patients With Relapsed and Refractory Aggressive Lymphomas: Real-World Experiences From a Single Center on the Use of Radiotherapy.

Hematol Oncol. 2025-9

[2]
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Technol Cancer Res Treat. 2025

[3]
[Radiotherapy of non-Hodgkin lymphoma-discussion of modern treatment concepts and innovations].

Radiologie (Heidelb). 2025-6-11

[4]
Role of Radiation in Combination With CD30-Directed Chimeric Antigen Receptor T-Cell Therapy for Relapsed/Refractory Hodgkin Lymphoma.

Adv Radiat Oncol. 2023-12-23

[5]
Treatment strategies for relapse after CAR T-cell therapy in B cell lymphoma.

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[6]
Hypofractionated radiotherapy for refractory or relapsed aggressive B-cell lymphoma in the rituximab era.

BMC Cancer. 2024-1-13

[7]
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[8]
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[9]
Application of interim PET-CT in first-line treatment decision-making for lymphoma.

J Zhejiang Univ Sci B. 2023-10-15

[10]
The progress of novel strategies on immune-based therapy in relapsed or refractory diffuse large B-cell lymphoma.

Exp Hematol Oncol. 2023-8-14

本文引用的文献

[1]
CD19 CAR T cells following autologous transplantation in poor-risk relapsed and refractory B-cell non-Hodgkin lymphoma.

Blood. 2019-7-1

[2]
Radiation Therapy as a Bridging Strategy for CAR T Cell Therapy With Axicabtagene Ciloleucel in Diffuse Large B-Cell Lymphoma.

Int J Radiat Oncol Biol Phys. 2019-6-5

[3]
BCMA-Targeted CAR T-cell Therapy plus Radiotherapy for the Treatment of Refractory Myeloma Reveals Potential Synergy.

Cancer Immunol Res. 2019-5-21

[4]
Outcomes of patients with large B-cell lymphomas and progressive disease following CD19-specific CAR T-cell therapy.

Am J Hematol. 2019-8

[5]
Radiation, Immune Checkpoint Blockade and the Abscopal Effect: A Critical Review on Timing, Dose and Fractionation.

Front Oncol. 2018-12-13

[6]
Tisagenlecleucel in Adult Relapsed or Refractory Diffuse Large B-Cell Lymphoma.

N Engl J Med. 2018-12-1

[7]
Low-Dose Radiation Conditioning Enables CAR T Cells to Mitigate Antigen Escape.

Mol Ther. 2018-9-13

[8]
The promise of CAR T-cell therapy in aggressive B-cell lymphoma.

Best Pract Res Clin Haematol. 2018-9

[9]
The influence of radiation in the context of developing combination immunotherapies in cancer.

Ther Adv Vaccines Immunother. 2017-12

[10]
Role of Radiation Therapy in Patients With Relapsed/Refractory Diffuse Large B-Cell Lymphoma: Guidelines from the International Lymphoma Radiation Oncology Group.

Int J Radiat Oncol Biol Phys. 2018-3-1

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