Hyperfractionated Dual Equivalent Fractionated Bridging Radiation Therapy for the Treatment of Patients with Relapsed or Refractory Diffuse Large B-cell Lymphoma Undergoing T-cell Redirection Therapy
This clinical trial compares the effect of twice daily (BID) hyperfractionated dual equivalent fractionated (HyDEF) radiation therapy to once daily (QD) hypofractionated radiation therapy before standard T-cell redirection therapy (TRT) with chimeric antigen receptor (CAR) T-cell therapy or bispecific antibody (BsAb) therapy in treating patients with diffuse large B-cell lymphoma (DLBCL) that has come back after a period of improvement (relapsed) or that has not responded to previous treatment (refractory). Patients planning to undergo CAR T-cell therapy or bispecific antibody therapy often undergo radiation before these treatments. This is called bridging radiation. Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill cancer cells and shrink tumors. Hyperfractionated radiation therapy delivers smaller doses of radiation therapy over time and may kill more cancer cells and have fewer side effects. Hypofractionated radiation therapy delivers higher doses of radiation therapy over a shorter period of time and may kill more cancer cells and have fewer side effects. Giving HyDEF radiation therapy BID may be safe, tolerable and/or effective, compared to hypofractionated radiation therapy QD, in treating patients with relapsed or refractory (R/R) DLBC before undergoing CAR T-cell therapy or BsAb therapy.