Early experience using salvage radiotherapy for relapsed/refractory non-Hodgkin lymphomas after CD19 chimeric antigen receptor (CAR) T cell therapy
Brandon S. Imber
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorMichel Sadelain
Center for Cell Engineering and Immunology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorCarl DeSelm
Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA
Search for more papers by this authorConnie Batlevi
Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Department of Medicine, Center for Cellular Therapeutics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorRenier J. Brentjens
Department of Medicine, Center for Cellular Therapeutics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorParastoo B. Dahi
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorSergio Giralt
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorJae H. Park
Department of Medicine, Center for Cellular Therapeutics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorCraig Sauter
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorMichael Scordo
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorGunjan Shah
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorMiguel-Angel Perales
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorM. Lia Palomba
Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Department of Medicine, Center for Cellular Therapeutics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Joachim Yahalom and M. Lia Palomba contributed equally to this work as co-senior authorsSearch for more papers by this authorCorresponding Author
Joachim Yahalom
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Joachim Yahalom and M. Lia Palomba contributed equally to this work as co-senior authorsCorrespondence: Joachim Yahalom, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY 10065.
E-mail: [email protected]
Search for more papers by this authorBrandon S. Imber
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorMichel Sadelain
Center for Cell Engineering and Immunology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorCarl DeSelm
Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, USA
Search for more papers by this authorConnie Batlevi
Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Department of Medicine, Center for Cellular Therapeutics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorRenier J. Brentjens
Department of Medicine, Center for Cellular Therapeutics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorParastoo B. Dahi
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorSergio Giralt
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorJae H. Park
Department of Medicine, Center for Cellular Therapeutics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorCraig Sauter
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorMichael Scordo
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorGunjan Shah
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorMiguel-Angel Perales
Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorM. Lia Palomba
Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Department of Medicine, Center for Cellular Therapeutics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Joachim Yahalom and M. Lia Palomba contributed equally to this work as co-senior authorsSearch for more papers by this authorCorresponding Author
Joachim Yahalom
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Joachim Yahalom and M. Lia Palomba contributed equally to this work as co-senior authorsCorrespondence: Joachim Yahalom, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY 10065.
E-mail: [email protected]
Search for more papers by this authorSummary
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.
Conflict of Interest
M.S. (Sadelain) reports contract research from Fate Therapeutics, Atara Biotherapeutics and Takeda. C.B. reports research support from Janssen, Novartis, Epizyme, Xynomics, Bayer, Juno, BMS, Consultancy for Life Sci, GLG, Juno/Celgene, Seattle Genetics and Honoraria from Dava Oncology. R.J.B. reports royalties and grant support from Juno and serves as a consultant for Juno/Celgene. S.G. serves on the Advisory Board for Amgen, Actinuum, Celgene, Johnson & Johnson, Jazz Pharmaceuticals, Takeda, Novartis, Kite and Spectrum Pharmaceuticals and receives research funding from Amgen, Actinuum, Celgene, Johnson & Johnson, Miltenyi and Takeda. J.H.P. has a consulting role with Novartis, Amgen, Allogene, Autolus, Kite Pharma, Incyte, AstraZeneca, GSK and Takeda. C.S.S. has served as a consultant on advisory boards for Juno, Sanofi-Genzyme, Spectrum Pharmaceuticals, Novartis, Genmab, Precision Biosciences, Kite, Celgene and GSK and has received research funds for investigator-initiated trials from Juno and Sanofi-Genzyme. M.S. (Scordo) has served as a consultant for McKinsey & Company and Angiocrine Bioscience, Inc. G.S. has received research funding from Janssen and Amgen. M.A.P. reports honoraria from Abbvie, Bellicum, Bristol-Myers Squibb, Incyte, Merck, Novartis, Nektar Therapeutics and Takeda serves on DSMBs for Servier and Medigene and the scientific advisory boards of MolMed and NexImmune, and has received research support for clinical trials from Incyte and Miltenyi Biotec. M.L.P. serves on the scientific advisory board for Celgene and is a consultant for Pharmacyclics. B.I., C.D. and J.Y. report no competing financial interests.
Supporting Information
| Filename | Description |
|---|---|
| bjh16541-sup-0001-FigS1.tifTIFF image, 5.1 MB |
Figure S1. Post CART patterns of failure for the 6 patients with localized disease at the time of SRT. Note that the site treated with RT is denoted with a blue arrow. All 6 patients ultimately had refractory or relapsed disease in a site that was avid prior to CART. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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