1. Prevalence of non-Hodgkin lymphoma patients at high-risk of failure after CAR T-cell therapy eligible for bridging radiation therapy.
- Author
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Danish A, Della Pia A, Fogel L, Alkhatatneh H, Zhao C, Varughese T, Al Feghali KA, Pascual L, Sinclaire B, Marafelias M, Zenreich J, Kuo YH, Feldman TA, Zhang Y, Goy AH, Ip A, and Rowley SD
- Abstract
Background and Purpose: The aim of this study was to determine the prevalence of patients with relapsed or refractory (R/R) non-Hodgkin lymphoma (NHL) meeting high-risk criteria for early relapse after CD19 CAR T-cell therapy (CART) who have disease encompassable in a standard radiation therapy (RT) plan (defined as <5 malignant lesions) and may benefit from bridging RT prior to CD19 CART., Materials and Methods: This is a single-center, retrospective study of patients with R/R NHL who received CD19 CART from 2018 to 2022. Eligible patients had pre-apheresis radiologic studies available. All patients were classified by number of lesions and history of high-risk disease criteria: bulky disease ≥10 cm, ≥1 extranodal (EN) sites, LDH ≥normal, or ≥1 lesion with SUVmax ≥10., Results: A total of 81 patients with R/R NHL were evaluated. Based on our definition, 40 (49%) patients would have been eligible for bridging RT, including 38 patients who met high-risk criteria: 31 with ≥1 EN site, 19 had ≥1 lesion with SUVmax ≥10, 16 with bulky disease, and 3 with elevated LDH. At 3 months after CART, ORRs in high-risk patients with <5 lesions, ≥5 lesions, and no lesions on pre-apheresis studies were 76% (CR 69%, PR 7%), 70% (CR 60%, PR 10%), and 80% (CR 80%), respectively., Conclusion: Approximately 47% (38/81) of patients were classified as at high risk of relapse after CART with disease encompassable in a standard radiation plan and eligible for bridging RT studies., Competing Interests: KA: RefleXion Medical: Employee, Stock, and Stock Options. TF: Abbvie: Consultancy, Advisory Board, Speakers Bureau; ADC Therapeutics: Consultancy, Advisory Board; Astrazeneca: Consultancy, Advisory Board, Research Funding; Celgene/BMS: Speakers Bureau, Research Funding; Corvus: Research Funding; Daiichi Sakyo: Consultancy, Advisory Board, Research Funding; Eisai: Research Funding; Genmab: Consultancy, Advisory Board, Research Funding; Janssen Biotech, Inc.: Speakers Bureau; Juno: Research Funding; Karyopharm: Consultancy, Advisory Board; Kite, a Gilead Company: Consultancy, Advisory Board; Kymera: Research Funding; MorphoSys: Consultancy, Advisory Board; Research Funding; Pharmacyclics LLC: Speakers Bureau; Portola: Research Funding; Poteligeo: Speakers Bureau; SecuraBIO: Consultancy, Advisory Board; Seattle Genetics: Speakers Bureau, Research Funding; Takeda: Speakers Bureau; Tessa: Research Funding; Genomic Testing Cooperative: Other: Equity holder in privately-traded company. AG: Janssen: Membership on an entity’s Board of Directors, Advisory Board, Research Funding; Advisory Board, Honoraria; AbbVie/Pharmacyclics: Advisory Board, Consultancy, Honoraria, Research Funding; Kite, a Gilead Company: Consultancy, Honoraria, Membership on an entity’s Board of Directors, Advisory Board, Research Funding; AstraZeneca: Advisory Board, Honoraria, Research Funding to Institution, Membership on an entity’s Board of Directors; Acerta: Membership on an entity’s Board of Directors, Honoraria, Research Funding; Bristol Meyers Squibb/Celgene: Advisory Board, Consultancy, Honoraria, Research Funding; Constellation: Research Funding; Hackensack Meridian Health, Regional Cancer Care Associates/OMI: Current Employment, Research Funding; Hoffman la Roche: Consultancy, Research Funding, Honoraria; Infinity/Verastem: Research Funding; Karyopharm: Research Funding; Xcenda: Honoraria, Consultancy; Vincerx: Honoraria, Advisory Board; Michael J Hennessey Associates INC: Honoraria; OncLive Peer Exchange: Honoraria; COTA (Cancer Outcome Tracking Analysis): Current holder of stock options in a privatelyheld company, Membership on an entity’s Board of Directors, Other: Leadership role; Genomic Testing Cooperative: Current holder of stock options in a privately-held company, Membership on an entity’s Board of Directors, Other: Leadership role; Practice Update Oncology: Consultancy, Honoraria; Physicians’ Education Resource: Honoraria, Consultancy; Novartis: Honoraria; Clinical Advances in Hematology/Oncology: Honoraria; 3rd GCC Hematoogy Expert Forum: Consultancy; Alloplex: Advisory Board, Honoraria; Peer Review: Membership on an entity’s Board of Directors. AI: Merck: Current holder of stock options in a privately-held company; COTA: Current holder of stock options in a privately-held company; MJH Life Sciences: Honoraria; TG Therapeutics: Consultancy, Advisory Board; Secura Bio: Consultancy, Advisory Board; AstraZeneca: Speakers Bureau; Seattle Genetics: Speakers Bureau; Genomic Testing Cooperative: Other: Equity holder in privatelytraded company. SR: ReAlta Life Sciences: Consultancy; SIR-Pant Immunotherapeutics: Advisory Board; COTA: Stock; Genomic Testing Cooperative: Stock. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Danish, Della Pia, Fogel, Alkhatatneh, Zhao, Varughese, Al Feghali, Pascual, Sinclaire, Marafelias, Zenreich, Kuo, Feldman, Zhang, Goy, Ip and Rowley.)
- Published
- 2024
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