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

Eric L. Smith, Sham Mailankody, Mette Staehr, Xiuyan Wang, Brigitte Senechal, Terence J. Purdon, Anthony F. Daniyan, Mark B. Geyer, Aaron D. Goldberg, Elena Mead, Bianca D. Santomasso, Jonathan Landa, Andreas Rimner, Isabelle Riviere, Ola Landgren, Renier J. Brentjens

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

We present a case of a patient with multiply relapsed, this response, which resembled cytokine-release syn-refractory myeloma whose clinical course showed evi-drome, immediately following XRT, we investigated dence of a synergistic abscopal-like response to chimeric changes in the patient's T-cell receptor (TCR) repertoire antigen receptor (CAR) T-cell therapy and localized radio-over 10 serial time points. Comparing T-cell diversity via therapy (XRT). Shortly after receiving B-cell maturation Morisita's overlap indices (CD), we discovered that, antigen (BCMA)–targeted CAR T-cell therapy, the patient although the diversity was initially stable after CAR T-cell required urgent high-dose steroids and XRT for spinal therapy compared with baseline (CD ¼ 0.89–0.97, base-cord compression. Despite the steroids, the patient had line vs. 4 time points after CAR T cells), T-cell diversity a durable systemic response that could not be attributed changed after the conclusion of XRT, with >30% newly to XRT alone. Post-XRT findings included a second wave expanded TCRs (CD ¼ 0.56–0.69, baseline vs. 4 time of fever and increased CRP and IL6, beginning 21 days points after XRT). These findings suggest potential synergy after CAR T cells, which is late for cytokine-release syn-between radiation and CAR T-cell therapies resulting in an drome from CAR T-cell therapy alone on this trial. Given abscopal-like response.

Original languageEnglish (US)
Pages (from-to)1047-1053
Number of pages7
JournalCancer Immunology Research
Volume7
Issue number7
DOIs
StatePublished - 2019
Externally publishedYes

ASJC Scopus subject areas

  • Immunology
  • Cancer Research

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