BCMA-Targeted CAR T-cell Therapy plus Radiotherapy for the Treatment of Refractory Myeloma Reveals Potential Synergy.


Journal

Cancer immunology research
ISSN: 2326-6074
Titre abrégé: Cancer Immunol Res
Pays: United States
ID NLM: 101614637

Informations de publication

Date de publication:
07 2019
Historique:
received: 14 08 2018
revised: 15 02 2019
accepted: 30 04 2019
pubmed: 23 5 2019
medline: 10 9 2020
entrez: 23 5 2019
Statut: ppublish

Résumé

We present a case of a patient with multiply relapsed, refractory myeloma whose clinical course showed evidence of a synergistic abscopal-like response to chimeric antigen receptor (CAR) T-cell therapy and localized radiotherapy (XRT). Shortly after receiving B-cell maturation antigen (BCMA)-targeted CAR T-cell therapy, the patient required urgent high-dose steroids and XRT for spinal cord compression. Despite the steroids, the patient had a durable systemic response that could not be attributed to XRT alone. Post-XRT findings included a second wave of fever and increased CRP and IL6, beginning 21 days after CAR T cells, which is late for cytokine-release syndrome from CAR T-cell therapy alone on this trial. Given this response, which resembled cytokine-release syndrome, immediately following XRT, we investigated changes in the patient's T-cell receptor (TCR) repertoire over 10 serial time points. Comparing T-cell diversity via Morisita's overlap indices (

Identifiants

pubmed: 31113804
pii: 2326-6066.CIR-18-0551
doi: 10.1158/2326-6066.CIR-18-0551
pmc: PMC6606365
mid: NIHMS1528833
doi:

Substances chimiques

B-Cell Maturation Antigen 0
Receptors, Antigen, T-Cell 0
TNFRSF17 protein, human 0

Types de publication

Case Reports Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1047-1053

Subventions

Organisme : NIH HHS
ID : U54 OD020355
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA138738
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCI NIH HHS
ID : P01 CA190174
Pays : United States
Organisme : NCI NIH HHS
ID : P01 CA059350
Pays : United States
Organisme : NCI NIH HHS
ID : K12 CA184746
Pays : United States

Informations de copyright

©2019 American Association for Cancer Research.

Références

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Auteurs

Eric L Smith (EL)

Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. smithe3@mskcc.org brentjer@mskcc.org.
Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Sham Mailankody (S)

Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Mette Staehr (M)

Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Xiuyan Wang (X)

Cell Therapy and Cell Engineering Facility, Memorial Sloan Kettering Cancer Center, New York, New York.

Brigitte Senechal (B)

Cell Therapy and Cell Engineering Facility, Memorial Sloan Kettering Cancer Center, New York, New York.

Terence J Purdon (TJ)

Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Anthony F Daniyan (AF)

Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Mark B Geyer (MB)

Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Aaron D Goldberg (AD)

Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Elena Mead (E)

Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Bianca D Santomasso (BD)

Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York.
Parker Institute for Cancer Immunotherapy, San Francisco, California.

Jonathan Landa (J)

Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.

Andreas Rimner (A)

Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.

Isabelle Riviere (I)

Cell Therapy and Cell Engineering Facility, Memorial Sloan Kettering Cancer Center, New York, New York.

Ola Landgren (O)

Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Renier J Brentjens (RJ)

Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. smithe3@mskcc.org brentjer@mskcc.org.
Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

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Classifications MeSH