Car-t relapse

This is rubbish Alice, I was looking in your profile to see if you have had a SCT before...... have you?

CAR-T is all new to me but let’s see if anyone has some info for you ((hugs))

EDIT - Just checked back your posts and you did not have a SCT......... An Allo SCT can still to the job but lets see if your tam can do their magic and not have to go down this road.

Yes it is rubbish has anyone on here had a allo for dblc and is it still working?

Thanks

Alice x

Alice, Fred Hutch and the Mayo Clinic have been doing some trials where left over cells are given or a second car-t treatment but its very early days and this is all in the US so may not be available here, do you know if any cells were stored incase more where needed?

It is worth ensuring that they talk to others around the world to see what is the next best step, given the fact car-t is still relatively new. 

John 

Hi, so sorry to hear about relapse but just heard about this new treatment for post Car-T relapse over in the USA; Polivy.
Polatuzumab (another immunotherapy drug) with Bendamustine and Revlimid. .

might be worth asking about....apparently it got approval last summer.

Hugs xxx

Oh,. Alice, I'm sorry. That's my sort of luck....now waiting for scan to see if mines back....3 months after complete remission from auto stem cell transplant. I'm on a car-t Facebook page which is mainly Americans, a few UK based. There are some that have relapsed after car-t and gone on to full remission. Things are changing all the time. Wishing you the best

Lynda xx

Hi Alice, saw this on lymphoma hub where they are starting to look at why this treatment may fail and possible next steps, thought the paragraph on early relapse may be of interest towards the end of the report.

here is the link https://lymphomahub.com/medical-information/why-patients-with-large-b-cell-lymphoma-fail-car-t-therapy-and-how-to-manage-them?fbclid=IwAR0SbGnNHOYaPQ1CS228WzVnOxCe43mtR7iVq_4CeVEpa3IE-PHUMNMGE9Q

and this is what it says if you don't want to read it all

Patients who respond to CAR T treatment but relapse early within <3 months following CAR T infusion are advised to follow-up with standard salvage strategies like chemotherapy, radiation and/or immunomodulatory drugs (IMiDs).  Off-label administration of the anti-PD-1 antibodies pembrolizumab and nivolumab has shown promising activity in this patient subgroup when given within a month after CAR-T infusion. Interestingly, both inhibitors improved the expansion and function of the infused CAR T cells and increased immunity, leading to good clinical responses. Another study reported an overall response rate (ORR) of 27% following pembrolizumab administration in patients with CAR T failure. Clinical enrolment in an appropriate, well-designed trial should also be considered.

hope you find it helpful

John 

Thanks John

Fortunately pet scan showed relapse is quite small and got few options to get me to remission and then.do allo stem cell transplant. 

Alice 

Thank you will do x

Alice that sounds better though still not idea, if it were me then I would be discussing maintenance treatment post transplant to increase the chances of long term success, if I remember correctly the have been some trials looking at this over the last 5 years or so.

John 

This is a good positive foundation to build on and move this all forward in a positive may xx