Clin Cancer Res: Patients with multiple myeloma can safely use bridging radiotherapy for CAR T cell therapy!

Multiple myeloma is still incurable
.

Chimeric antigen receptor (CAR) T cells (CART-BCMA) targeting B cell maturation antigen (BCMA) is a promising method for the treatment of relapsed/refractory multiple myeloma (r/rMM)

Chimeric antigen receptor (CAR) T cells (CART-BCMA) targeting B cell maturation antigen (BCMA) is a promising method for the treatment of relapsed/refractory multiple myeloma (r/rMM)

Patients with r/rMM often require radiotherapy (RT) to relieve symptoms
.

In addition to local effects, RT also has a systemic immunomodulatory effect

Some immune patients need radiotherapy as a bridge to quickly relieve symptoms or maintain functional status (ie, bridging radiotherapy) before CART-BCMA treatment

A total of 25 r/rMM subjects received two doses of CART-BCMA cells with or without cyclophosphamide in 3 cohorts
.

Researchers retrospectively analyzed the toxicity, treatment response and CART production data of the tested patients

Thirteen subjects did not undergo RT treatment within one year before receiving CART infusion (group A)
.

Eight subjects had undergone RT treatment within one year before receiving CART infusion (group B), and the median time from RT to apheresis was 114 days (range 40-301 days)

4 subjects underwent bridging-RT (group C), the median RT dose was 22 Gy, and the median interval from RT to CART infusion was 25 days (range 18-35 days)

The overall survival of the three groups of patients

The overall survival of the three groups of patients

The incidence of grade 4 (G4) hematological toxicity in group C was significantly lower than that in groups A and B (25% vs 61.
5% vs 62.
5%)
.

The incidence of grade 3-4 neurotoxicity in group A, group B, and group C were 7.

The incidence of grade 4 (G4) hematological toxicity in group C was significantly lower than that in groups A and B (25% vs 61.

Progression-free survival of the three groups of patients

Progression-free survival of the three groups of patients

The proportions of patients in group A, group B, and group C that achieved partial and better remission were 54%, 38%, and 50%, respectively
.

The administration of RT within one year and 100 days before apheresis was associated with the slower proliferation of T cells in vitro during the production process (p values ​​were 0.

The proportions of patients in group A, group B, and group C that achieved partial and better remission were 54%, 38%, and 50%, respectively

In r/rMM patients receiving CART-BCMA, bridging radiotherapy seems to be safe and feasible.
In r/rMM patients receiving CART-BCMA, bridging radiotherapy seems to be safe and feasible.

Original source:

Original source:

Shwetha H Manjunath, et al.
The Safety of Bridging Radiation with Anti-BCMA CAR T-Cell Therapy for Multiple Myeloma .
Clin Cancer Res September 15 2021 DOI:10.
1158/1078-0432.
CCR-21-0308

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