Radiation therapy as a bridging and salvage strategy in patients with relapsed or refractory multiple myeloma undergoing BCMA-targeted CAR T-cell therapy

Hazim S Ababneh; Andrew J Yee; Noopur S Raje; Sidney Martin; Matthew J Frigault; Andrea K Ng; Chirayu G Patel

doi:10.1016/j.radonc.2023.109933

Radiation therapy as a bridging and salvage strategy in patients with relapsed or refractory multiple myeloma undergoing BCMA-targeted CAR T-cell therapy

Radiother Oncol. 2023 Dec:189:109933. doi: 10.1016/j.radonc.2023.109933. Epub 2023 Sep 30.

Authors

Hazim S Ababneh¹, Andrew J Yee², Noopur S Raje², Sidney Martin¹, Matthew J Frigault², Andrea K Ng³, Chirayu G Patel⁴

Affiliations

¹ Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
² Division of Hematology & Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
³ Department of Radiation Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁴ Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: [email protected].

PMID: 37778534
DOI: 10.1016/j.radonc.2023.109933

Abstract

Radiation therapy (RT) may play an important role prior to and following BCMA-targeted CAR T-cell therapy in multiple myeloma (MM). We report a series of 13 patients: 5 patients received bridging RT pre-CAR T, 4 patients received salvage RT post-CAR T failure, and 4 patients received both. There was no worsening of CAR-T- or RT-related toxicities. The RT in-field local control rate was 100%, with a median follow-up after each RT course of 7.3 months. RT as a bridging and salvage strategy is safe, feasible, and offers excellent local control in MM patients treated with CAR T-cell therapy.

Keywords: CAR T-cell therapy; Multiple myeloma; Radiation therapy.

MeSH terms

B-Cell Maturation Antigen / therapeutic use
Humans
Immunotherapy, Adoptive / adverse effects
Multiple Myeloma* / drug therapy
Multiple Myeloma* / radiotherapy
Receptors, Chimeric Antigen* / therapeutic use

Substances

Receptors, Chimeric Antigen
B-Cell Maturation Antigen