ArticleActa oncologica (Stockholm, Sweden)2026
Association between CAR T-cell persistence and improved response to salvage radiotherapy in patients with DLBCL.
Article in Acta oncologica (Stockholm, Sweden), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
background and purposeWhile Chimeric antigen receptor (CAR) T-cell therapy has transformed treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL), over half of patients relapse within 1 year with poor prognosis. Salvage radiotherapy (sRT) achieves high local response rates, but which subgroups benefit most and whether CAR T-cell persistence influences sRT response remains unclear. Patient/material and methods: We retrospectively analyzed DLBCL patients receiving sRT after CAR T-cell therapy at our center. CAR transgene levels were quantified by quantitative polymerase chain reaction (qPCR), and associations between CAR T-cell kinetics at relapse, sRT response, and survival were evaluated.
resultsCAR transgene data were available for 13 patients, (18 lesions treated with sRT). Toxicity was mild (grade ≤ 2). The local response rate was 83% (15/18 lesions). Three CAR transgene kinetic patterns were identified at relapse: increased-CAR (second increase in transgene levels, n = 4), persisted-CAR (persistence > 6 months, n = 4), and decreased-CAR (decline or absence, n = 5). Local response rates were 100% in both the increased- and persisted-CAR groups versus 57% (4/7 lesions) in the decreased-CAR group, 12-month local control rates were 83, 100, and 14%, respectively. Twelve-month overall survival was 100% in both increased-CAR and persisted-CAR groups versus 20% in the decreased-CAR group.
interpretationsRT may provide durable local control in relapsed DLBCL after CAR T-cell therapy. Persistent CAR T-cell activity at relapse may help identify patients most likely to benefit from comprehensive sRT. Given the small, heterogeneous cohort, these findings are hypothesis-generating and require validation in larger series.
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