How soon after CAR T-cell therapy can salvage radiation be delivered?  

This is another important question. In our practice, the earliest we have treated patients is after their first post-CAR-T PET/CT at day 30. An abstract presented in an oral presentation at this year's ASTRO meeting by Dr. @Saifi describes that radiation to sites of incomplete response at this ...

In our practice, we routinely obtain a day+30 PET scan to evaluate response after CAR T-cell therapy. If there is a residual disease, particularly, a limited residual disease with a Deauville score of 4-5, we offer salvage radiation therapy at this point in time. While acknowledging that 20-30% of ...

For small sites or rapidly progressive diseases, we have used radiation much more often prior to CAR T cell therapy, right after T cells have been collected (“bridging” instead of chemo). This worked out surprisingly well and these patients have had excellent disease control.