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.
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。
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