CAR T-cell Therapy for Secondary CNS DLBCL.

Management of secondary central nervous system involvement (SCNSL) in relapsed or refractory aggressive B-cell lymphomas remains an area of unmet medical need. We report a single center retrospective analysis of seven adult patients with SCNSL who underwent CAR-T therapy for their refractory disease and describe safety of whole brain radiation as a bridging therapy. Six patients (85.7%) achieved a complete response at D+28, while 1 patient had progressive disease. The median progression free survival was 83 days (28 - 219) and a median overall survival was 129 days (32 - 219). Three patients died due to disease progression. Of the 5 patients who received WBRT as bridging therapy, 3 had no ICANS, while 2 had grade 1 and 3, respectively. No grade 4 ICANS was reported in this subset of patients. We conclude that SCNSL should not preclude someone for CAR-T as a treatment option due to concerns of ICANS and bridging with WBRT is not associated with increased ICANS.