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Cederquist, Gustav Y.; Schefflein, Javin; Devlin, Sean M.; Shah, Gunjan L.; Shouval, Roni; Hubbeling, Harper; Tringale, Kathryn; Alarcon Tomas, Ana; Fregonese, Beatrice; Hajj, Carla; Boardman, Alexander; Luna De Abia, Alejandro; Corona, Magdalena; Cassanello, Giulio; Dahi, Parastoo B.; Lin, Richard J.; Ghione, Paola; Salles, Gilles; Perales, Miguel-Angel; Palomba, M. Lia; Falchi, Lorenzo; Scordo, Michael; Grommes, Christian; Yahalom, Joachim; Imber, Brandon S.
Blood advancesJournal Article
•BRT for chemotherapy-refractory CNS lymphoma achieves rapid cytoreduction before CART.•CNS-BRT is associated with a favorable CNS response profile and CART–associated neurotoxicity profile. Display omitted Chimeric antigen receptor (CAR) T-cell therapy (CART) for central nervous system lymphoma (CNSL) is a promising strategy, yet responses are frequently not durable. Bridging radiotherapy (BRT) is used for extracranial lymphoma in which it can improve CART outcomes through cytoreduction of high-risk lesions. We hypothesized that BRT would achieve similar, significant cytoreduction before CART for CNSL (CNS-BRT). We identified patients with CNSL with non-Hodgkin B-cell lymphoma who received CNS-BRT before commercial CART. Cytoreduction from CNS-BRT was calculated as change in lesion size before CART. Twelve patients received CNS-BRT, and the median follow-up among survivors is 11.8 months (interquartile range, 8.5-21.9). Ten patients had CNSL (9 secondary, 1 primary) and 2 patients had epidural disease (evaluable for toxicity). All 10 patients with CNSL had progressive disease at the time of CNS-BRT. Of 12 patients, 1 experienced grade ≥3 cytokine release syndrome, and 3 of 12 patients experienced grade ≥3 immune effector cell–associated neurotoxicity syndrome. CNS-BRT achieved a 74.0% (95% confidence interval, 62.0-86.0) mean reduction in lesion size from baseline (P = .014) at a median of 12 days from BRT completion and before CART infusion. Best CNS response included 8 complete responses, 1 partial response, and 1 progressive disease. Three patients experienced CNS relapse outside the BRT field. Preliminary data suggest CNS-BRT achieves rapid cytoreduction and is associated with a favorable CNS response and safety profile. These data support further study of BRT as a bridging modality for CNSL CART.
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Dostop do baze podatkov JCR je dovoljen samo uporabnikom iz Slovenije. Vaš trenutni IP-naslov ni na seznamu dovoljenih za dostop, zato je potrebna avtentikacija z ustreznim računom AAI.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Vir: Osebne bibliografije
in: SICRIS
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