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Combining CAR-T therapy with radiotherapy or not in refractory/relapsed diffuse large B-cell lymphoma: A comparative
Yun Yang1, Bichun Xu1, Hong Zhu1
1Department of Radiotherapy, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Clinical and Translational Radiation Oncology
|September 24, 2025
Summary
Bridging radiotherapy (BRT) before CAR-T therapy significantly improves progression-free survival and overall survival in refractory/relapsed diffuse large B-cell lymphoma (R/R DLBCL) patients. BRT is a safe and effective approach, potentially enhancing CAR-T anti-tumor effects.
Area of Science:
- Hematology
- Oncology
- Radiation Oncology
Background:
- Chimeric Antigen Receptor (CAR)-T therapy shows promise for refractory/relapsed diffuse large B-cell lymphoma (R/R DLBCL).
- Radiotherapy and CAR-T therapy may have synergistic effects, improving patient prognosis.
- Standardized protocols for bridging radiotherapy (BRT) before CAR-T therapy are lacking.
Purpose of the Study:
- To evaluate the efficacy and safety of BRT prior to CAR-T therapy in R/R DLBCL patients.
- To assess the impact of BRT dose on patient prognosis.
- To analyze the outcomes of R/R DLBCL patients treated with or without BRT before CAR-T.
Main Methods:
- Retrospective analysis of 80 R/R DLBCL patients treated with CAR-T between December 2017 and January 2025.
- Comparison of outcomes (PFS, OS, DSS, ORR, CRR) between patients who received BRT (n=35) and those who did not.
- Subgroup analysis of radiotherapy dose (EQD2) and BRT modality (comprehensive vs. focal).
Main Results:
- BRT group demonstrated significantly longer PFS and OS compared to the no BRT group (p=0.001, p=0.043).
- BRT did not increase CAR-T toxicities; comprehensive BRT improved PFS and OS (p=0.015, p=0.029).
- High-EQD2 BRT showed a trend towards improved local control (p=0.079), especially in high tumor burden patients (p=0.005).
Conclusions:
- BRT is an effective and safe bridging strategy for R/R DLBCL patients undergoing CAR-T therapy.
- BRT may enhance the anti-tumor efficacy of CAR-T cells.
- Further research into optimal BRT dosing and techniques is warranted.
Keywords:
Bridging radiotherapyCAR-T therapyPrognosisrefractory/relapsed diffuse large B-cell lymphomaMore Related Videos
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