ICML 2025 | The potential benefits of combining radiation and CAR T-cell therapy to treat lymphoma

We had a workshop here. The International Lymphoma Radiotherapy and Oncology Group is collaborating with the ICML to do workshops and we’ve done that for many years now and we had a workshop exactly on that point where we talked about the use of radiation therapy in combination with CAR T-cell therapy. It started with, you know, CAR T-cell takes some time to be produced, so bridging with some sort of treatment was necessary, and radiation therapy is very well suited for that because most of these lymphomas are still sensitive to radiation therapy, and we can, with modern techniques, we can irradiate exactly the areas that need it. But it turned out then that it’s also clear that patients who receive CAR T-cell therapy, they have a better prognosis the smaller the tumor burden. So one other function of radiation therapy in that context is that it reduces the tumor burden. We usually irradiate bulky tumors and they diminish in size, so the tumor burden has been lower. And the British group at this workshop presented their data on their program where bridging with radiation therapy has had a prominent place and they could demonstrate that patients who had been bridged with radiation therapy have as good a prognosis as the patients who didn’t need bridging at all and that would be the patients with a small tumor burden. So this is of course a retrospective study, we’ll need prospective studies to really demonstrate which patients will benefit. But it certainly is a very promising approach. But the third thing which is really interesting is the idea of radiation therapy priming either the tumor cells or the T-cells or the microenvironment of the lymphomas to achieve better results to augment the effect of the CAR T-cells. And this is an area of investigation because we don’t exactly know how to harness this effect because there are so many different effects of radiation therapy on the tumor cells and the environment. And Carl DeSelm gave an excellent lecture on this at our workshop because there are good and bad effects of radiation therapy. So the challenge is to harness these effects to get the good out of radiation therapy and avoid the bad effects. So this is something which is ongoing and it’s a very promising and very very interesting field.

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