5-5-5 ABRT (Dose of 5 Gy per Fraction for up to 5 Fractions Over 5 Weeks Adaptive Bridging Radiation Therapy)-Artificial Intelligence Enters the CAR (-T) (Chimeric Antigen Receptor-T) in Relapsed/Refractory Large B Cell Lymphoma.

Purpose: Bridging radiation therapy (BRT) is effective for local control in patients with relapsed or refractory large B cell lymphoma who are undergoing chimeric antigen receptor (CAR) T cell therapy. We hypothesized that adaptive BRT (ABRT), which can be used to personalize the radiation dose, fractionation, and volume based on real-time lymphoma target volume, is feasible, safe, and effective for local control.

Methods And Materials: We conducted a pilot study to investigate, once weekly, computed tomography-based adaptive radiation therapy (Varian Ethos) at a dose of 5 Gy per fraction for up to 5 fractions over 5 weeks in patients referred for BRT (NCT06004167).

Post-CAR T-Cell Therapy Failure Metabolic Parameters Predict Survival and Response in Large B-Cell Lymphoma.

18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) parameters have shown a significant prognostic role in relapsed/refractory large B-cell lymphoma (LBCL) patients undergoing CD19-targeted chimeric antigen receptor (CAR) T-cell therapy. While a substantial body of evidence exists on the prognostic value of PET/CT parameters in peri-CAR T setting, data available on the prognostic value of PET/CT parameters following CAR T-cell therapy failure is lacking. Therefore, we sought to analyze the PET/CT scans of LBCL patients who experienced post-CAR T relapsed/progressive disease and subsequently received salvage therapies.

Breaking Traditions: Evaluating Single Fraction Radiation in Indolent Lymphoma.

As indolent non-Hodgkin's lymphomas (iNHLs) are very radiosensitive, radiation treatment (RT) has been established as an essential curative and palliative modality for early and advanced stages of the disease. Several studies have explored the role of very low-dose RT for palliation in indolent non-Hodgkin's lymphomas, demonstrating that this approach can lead to high rates of local control, and thereby, help improve the quality of life for these patients. While the most common schedule of very low-dose RT used in the palliative setting is 4Gy in 2 fractions, which was established in the landmark FoRT trial, this requires patients to be available for two RT sessions, increasing the financial and opportunity costs for the patient.

Metabolic parameters predict survival and toxicity in chimeric antigen receptor T-cell therapy-treated relapsed/refractory large B-cell lymphoma.

CD19-targeted chimeric antigen receptor (CAR) T-cell therapy has revolutionized treatment for patients with relapsed/refractory large B-cell lymphoma (LBCL). However, data available concerning the impact of the prognostic value of quantitative 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) parameters on the CAR T-related outcomes and toxicities are limited. Therefore, we aimed to evaluate the predictive value of pre- and post-CAR T metabolic parameters on survival and toxicities following CAR T-cell therapy.

Salvage radiotherapy in relapsed/refractory large B-cell lymphoma after failure of CAR T-cell therapy.

Despite the success of CD19-targeted chimeric antigen receptor (CAR T)-cell therapy in patients with relapsed/refractory large B-cell lymphoma (LBCL), there is a need for effective salvage strategies post-CAR T-cell therapy failure. We conducted a multi-institutional retrospective study of patients who relapsed following CAR T-cell therapy (axicabtagene ciloleucel [axi-cel] or tisagenlecleucel [tisa-cel]) and received salvage therapies (radiation therapy [RT] alone, systemic therapy alone, or combined modality therapy [CMT]). A total of 120 patients with post-CAR T relapsed LBCL received salvage therapies (RT alone, 25 patients; CMT, 15 patients; systemic therapy alone, 80 patients).

Sarcoma brain metastases: Tertiary cancer center experience.

Objective: Brain metastasis (BM) from bone and soft tissue sarcomas (STS) is very rare and mostly predicts dismal prognosis. Owing to its' rarity, data on optimal therapy including surgical management, chemotherapy, and radiotherapy is scarce. We sought to assess the prevalence, disease characteristics, and outcomes of BM in bone and STS patients treated at a single institution.

Assessing the role of radiotherapy in patients with refractory or relapsed high-grade B-cell lymphomas treated with CAR T-cell therapy.

An estimated 30-40% of patients with diffuse large B cell lymphoma (DLBCL) will either relapse or have refractory disease with first-line chemoimmunotherapy. The standard approach for relapsed/refractory disease is salvage chemotherapy followed by autologous stem cell transplantation, but this approach cures fewer than 20% of patients in the modern era. This low cure rate is a result of refractory disease despite salvage therapy, medical ineligibility for transplantation, or relapse following transplantation.