Delayed Terminal Ileal Perforation in a Relapsed/Refractory B-Cell Lymphoma Patient with Rapid Remission Following Chimeric Antigen Receptor T-Cell Therapy

Hu, Yongxian; Wang, Jiasheng; Pu, Chengfei; Zhao, Kui; Cui, Qu; Wei, Guoqing; Wu, Wenjun; Xiao, Lanbo; Xiao, Yang; Wang, Jinping; Zhao, Weihong; Huang, He

doi:10.4143/crt.2017.473

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…Moreover, CAR-T cell-related adverse events occur even earlier than irAEs, even hours and days after the first application. In sum, there is only a small amount of literature describing late toxicities different from irAEs so far [78,79]. Hence, more clinical experience and, in particular, literature evaluating the use of PET imaging in CAR-T cell therapy are needed.…”

Section: Imaging Of Immune-related Adverse Eventsmentioning

confidence: 99%

PET/CT imaging for tumour response assessment to immunotherapy: current status and future directions

Ruzicka¹,

Fabritius

Mittlmeier

et al. 2020

Eur Radiol Exp

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Recent immunotherapeutic approaches have evolved as powerful treatment options with high anti-tumour responses involving the patient’s own immune system. Passive immunotherapy applies agents that enhance existing anti-tumour responses, such as antibodies against immune checkpoints. Active immunotherapy uses agents that direct the immune system to attack tumour cells by targeting tumour antigens. Active cellular-based therapies are on the rise, most notably chimeric antigen receptor T cell therapy, which redirects patient-derived T cells against tumour antigens. Approved treatments are available for a variety of solid malignancies including melanoma, lung cancer and haematologic diseases. These novel immune-related therapeutic approaches can be accompanied by new patterns of response and progression and immune-related side-effects that challenge established imaging-based response assessment criteria, such as Response Evaluation Criteria in Solid tumours (RECIST) 1.1. Hence, new criteria have been developed. Beyond morphological information of computed tomography (CT) and magnetic resonance imaging, positron emission tomography (PET) emerges as a comprehensive imaging modality by assessing (patho-)physiological processes such as glucose metabolism, which enables more comprehensive response assessment in oncological patients. We review the current concepts of response assessment to immunotherapy with particular emphasis on hybrid imaging with 18F-FDG-PET/CT and aims at describing future trends of immunotherapy and additional aspects of molecular imaging within the field of immunotherapy.

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Section: Imaging Of Immune-related Adverse Eventsmentioning

confidence: 99%

PET/CT imaging for tumour response assessment to immunotherapy: current status and future directions

Ruzicka¹,

Fabritius

Mittlmeier

et al. 2020

Eur Radiol Exp

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“…For chimeric antigen receptor (CAR)-T cell therapy in B-cell lymphoma, the situation is somehow different. At first, this therapeutic regimen is associated with other adverse effects, such as cytokine release syndrome (CRS), CAR-T cell-related neurologic toxicities, and B-cell aplasia, not commonly detectable with FDG PET [51,[58][59][60]. Secondarily, concurrent local inflammation is more frequently seen compared to the IAEs mentioned earlier for HL.…”

Section: Immune-related Adverse Eventsmentioning

confidence: 99%

Current Evidence on PET Response Assessment to Immunotherapy in Lymphomas

Lopci

Meignan

2020

PET Clinics

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“…In some cases, when the lymphoma is adjacent to the respiratory tracts, veins, gastrointestinal tracts, liver, or urinary system, these tissues may swell after the infusion of CAR-T cells and may compress the corresponding tracts or cavities, thereby causing dyspnea, venous reflux disorder, ileus, jaundice, back pain, and oliguria [96]. Furthermore, if the tumor cells invade a hollow organ thoroughly, perforation and bleeding may occur [97]. As mentioned previously, the pancytopenia commonly occurs after the CAR-T cell infusion.…”

Section: Localized Crs and Tumor Lysis Syndromementioning

confidence: 99%

A giant step forward: chimeric antigen receptor T-cell therapy for lymphoma

et al. 2020

Self Cite

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The combination of the immunotherapy (i.e., the use of monoclonal antibodies) and the conventional chemotherapy increases the long-term survival of patients with lymphoma. However, for patients with relapsed or treatment-resistant lymphoma, a novel treatment approach is urgently needed. Chimeric antigen receptor T (CAR-T) cells were introduced as a treatment for these patients. Based on recent clinical data, approximately 50% of patients with relapsed or refractory B-cell lymphoma achieved complete remission after receiving the CD19 CAR-T cell therapy. Moreover, clinical data revealed that some patients remained in remission for more than two years after the CAR-T cell therapy. Other than the CD19-targeted CAR-T, the novel target antigens, such as CD20, CD22, CD30, and CD37, which were greatly expressed on lymphoma cells, were studied under preclinical and clinical evaluations for use in the treatment of lymphoma. Nonetheless, the CAR-T therapy was usually associated with potentially lethal adverse effects, such as the cytokine release syndrome and the neurotoxicity. Therefore, optimizing the structure of CAR, creating new drugs, and combining CAR-T cell therapy with stem cell transplantation are potential solutions to increase the effectiveness of treatment and reduce the toxicity in patients with lymphoma after the CAR-T cell therapy.

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Delayed Terminal Ileal Perforation in a Relapsed/Refractory B-Cell Lymphoma Patient with Rapid Remission Following Chimeric Antigen Receptor T-Cell Therapy

Cited by 9 publications

References 15 publications

PET/CT imaging for tumour response assessment to immunotherapy: current status and future directions

PET/CT imaging for tumour response assessment to immunotherapy: current status and future directions

Current Evidence on PET Response Assessment to Immunotherapy in Lymphomas

A giant step forward: chimeric antigen receptor T-cell therapy for lymphoma

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