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Alhamss M, El Fakih R. Thinking Outside the Box in Mediastinal Lymphoma Management. Clin Hematol Int 2023:10.1007/s44228-023-00045-7. [PMID: 37195392 DOI: 10.1007/s44228-023-00045-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/29/2023] [Indexed: 05/18/2023] Open
Affiliation(s)
- Marwa Alhamss
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Riad El Fakih
- Section of Adult Hematology/HSCT, Oncology Centre, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11471, Saudi Arabia.
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Guerini AE, Filippi AR, Tucci A, Simontacchi G, Re A, Guaineri A, Morelli V, Borghetti P, Triggiani L, Pegurri L, Pedretti S, Volpi G, Spiazzi L, Magrini SM, Buglione M. 'Le Roi est mort, vive le Roi': New Roles of Radiotherapy in the Treatment of Lymphomas in Combination With Immunotherapy. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2021; 22:e135-e148. [PMID: 34728169 DOI: 10.1016/j.clml.2021.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/27/2021] [Accepted: 09/06/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND immunotherapy (IT), including checkpoint inhibitors (CIs) and Chimeric Antigen Receptor T cell therapy (CAR-T) revolutionized the treatment of relapsing or refractory (r/r) lymphoma. Several preliminary experiences evaluated concomitant administration of radiotherapy and IT. METHODS we performed a systematic review of current literature as of March 30, 2020. A total of 1090 records was retrieved, 42 articles were selected on the basis of title and abstract and, after the removal of analyses with no original data or insufficient clinical information, 28 papers were included in the review. RESULTS previous studies were mostly represented by case reports/series or small cohorts. Nonetheless, combination of radiotherapy and CIs or CAR-T led to promising outcomes, resulting in extremely high rates of complete response and improving progression free and overall survival compared with data from recent clinical trials. Combination of RT and CIs had a fair toxicity profile with no reports of severe side effects. Within the limits of the small cohorts retrieved, RT seems a superior option compared with systemic treatment as a 'bridge' to CAR-T and could as well reduce severe complications rates. Radiotherapy could elicit immune response against lymphoma, as demonstrated by multiple cases of abscopal effect and its inclusion in anti-neoplastic vaccines protocols. CONCLUSION The results of this review warrant the evaluation of combination of RT and immunotherapy in larger and preferably prospective and randomized cohorts to confirm these preliminary impressive outcomes. The optimal dose, fractionation and timing of RT still have to be clarified.
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Affiliation(s)
| | - Andrea Riccardo Filippi
- Radiation Oncology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Alessandra Tucci
- Department of Haematology, ASST-Spedali Civili Hospital, Brescia, Italy
| | - Gabriele Simontacchi
- Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Alessandro Re
- Department of Haematology, ASST-Spedali Civili Hospital, Brescia, Italy
| | - Annamaria Guaineri
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Vittorio Morelli
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Paolo Borghetti
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Ludovica Pegurri
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Sara Pedretti
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Giulia Volpi
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Luigi Spiazzi
- Medical Physics Department, ASST Spedali Civili Hospital, Brescia, Italy.
| | - Stefano Maria Magrini
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Michela Buglione
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
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Balzarotti M, Santoro A. Erratum to checkpoint inhibitors in primary mediastinal B-cell lymphoma: a step forward in refractory/relapsing patients? ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1474. [PMID: 33313219 PMCID: PMC7723609 DOI: 10.21037/atm-2020-40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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