The Fast CAR Race: Where Does Radiotherapy Place? Challenging Cases in the Cellular Therapy Era

This activity includes four challenging cases in lymphoma and myeloma with a panel of expert radiation oncologists, including one in private practice, and a medical oncologist. 1. Urgent need for debulking in extramedullary relapse of multiple myeloma after BCMA-targeted CAR T-cell therapy. Treatment/timeline will be summarized up to point of CAR T-cell therapy. Radiotherapy plans are detailed along with systemic therapy options. The case features several extramedullary relapses, showcasing how urgent radiotherapy allowed bridging to novel systemic therapies. 2. Consolidative radiotherapy for rel/ref large B-cell lymphoma after CAR T-cell therapy – newer data suggesting the utility of consolidative radiotherapy in patients with partial response or stable disease based on day 30 PET/CT are summarized. A case with limited sites of disease treated with consolidative radiotherapy is discussed. 3. Refractory CNS lymphoma – who completed bridging radiotherapy to CAR T-cell therapy. Discussion focuses on WBRT vs. focal RT, and dose/fractionation, with considerations to long-term outcomes with PFS and neurocognitive sequelae of RT. The available data on RT as a bridging strategy is summarized. 4. Bridging RT prior to CAR T in a patient with rapidly progressive refractory high-grade B cell lymphoma with plans for CAR T-cell therapy. Discussion focuses on options for bridging radiotherapy, including pros/cons of adaptive radiotherapy, and the range of dose/fractionation/field size. Non-conventional approaches are reviewed as well as what to do with a very compressed timeline to CAR T.

Topics:

  1. Case 1: Urgent Debulking RT in Myeloma Post-CAR T
    Andrew J. Yee, MD
    Chirayu G. Patel, MD, MPH
  2. Case 2: Post CAR T-cell Management
    Jennifer Peterson, MD
  3. Q and A - Part 1
    Chirayu G. Patel, MD, MPH - Moderator
    Full Panel
  4. Case 3: Refractory CNS Lymphoma - CAR T-cell Therapy
    Nicholas B. Figura, MD
  5. Q and A - Part 2
    Nicholas B. Figura, MD
  6. Final Case Discussion
    Full Panel

This activity is available from June 9, 2026, through 11:59 p.m. Eastern time on June 8, 2028. 

The content was originally presented and recorded at the 2025 ASTRO Annual Meeting.

Target Audience

The activity is designed to meet the interests of radiation oncologists.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Explain the factors that may influence radiation technique, dose, fractionation, and field size in the bridging, consolidation and salvage radiation for CAR T-cell therapy for lymphoma and multiple myeloma. 
  • Critically evaluate imaging for patients after CAR T-cell therapy and decide if patient should be considered for consolidative radiotherapy, and to what sites. 
  • Balance the goals and toxicity of bridging radiation therapy in patients with refractory CNS lymphoma undergoing CAR T-cell therapy. 
Course summary
Available credit: 
  • 1.25 AMA PRA Category 1 Credit™

    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 1.25 Certificate of Attendance
    This activity was designated for 1.25 AMA PRA Category 1 Credit™.
Course opens: 
06/09/2026
Course expires: 
06/08/2028
Cost:
$149.00
Rating: 
0

Moderators:  

  • Chirayu G. Patel, MD, MPH, is employed by Massachusetts General Hospital. Dr. Patel receives grant/research funding from Varian. 
  • Michael J. Yunes, MD, is employed by The American Board of Radiology and Pioneer Valley Radiation Oncology. Dr. Yunes owns stock options with Epistime Prognostics.  

Speakers:

  • Andrew J. Yee, MD, is employed by Massachusetts General Hospital. Dr. Yee receives compensation/payment from Jansson, E.R. Squibb & Sons, Celgene and Genentech. 
  • Jennifer L. Peterson, MD, is employed by Mayo Clinic Jacksonville. Dr. Peterson has no relevant financial relationship with ineligible companies to disclose. 
  • Nicholas B. Figura, MD, is employed by H. Lee Moffitt Cancer Center and Research Institute. Dr. Figura has no relevant financial relationship with ineligible companies to disclose.

Planners:

  • Malcolm Mattes, MD, is employed at Rutgers Cancer Institute. Dr. Mattes received research/grant funding from Gilead Sciences (relationship ended 8/30/2025). Dr. Mattes has no relevant financial relationship with ineligible companies. 
  • Parul Barry, MD, is employed by the University of Pittsburgh Medical Center. Dr. Barry has no relevant financial relationship with ineligible companies. 
  • Michael Haddock, MD, is employed by Mayo Clinic and has no relevant financial relationship with ineligible companies to disclose.
  • Manisha Palta, MD, is employed by Duke Cancer Center and Duke University Hospital. Dr. Palta receives grant/research funding from Merck and Varian Medical Systems. 
  • Salma Jabbour, MD, is employed by Rutgers Cancer Institute. Dr. Jabbour receives grant/research funding from Merck & Co., Inc. and Beigene. Dr. Jabbour receives compensation/payment as a consultant with Radialogica and IMX Medical. 
     

All relevant financial relationships have been mitigated.

The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Available Credit

  • 1.25 AMA PRA Category 1 Credit™

    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 1.25 Certificate of Attendance
    This activity was designated for 1.25 AMA PRA Category 1 Credit™.

Price

Cost:
$149.00
Please login or register to take this course.

Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.

  • Nonmember: $149
  • Member: $99
  • Member-in-Training: $49
  • Student/Graduate Student/PGY-1 Member: $49
  • Postdoctoral Fellow Member: $49

If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.

Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the activity by the expiration date. 

Participants using ASTRO Academy activities to satisfy the requirement of a Continuing Certification (MOC) program should verify the credit number and type and availability dates of any activity before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased activities that do not align with their MOC requirement.

The activity and its materials will only be available on the ASTRO website until June 8, 2028, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date. 

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