Which Patients Benefit from Radiation Therapy in Diffuse Large B-Cell Lymphoma in 2023? Recent Evidence and Future Developments

The role of RT in DLBCL is changing. Recent randomized studies have challenged the role of RT in the primary treatment of DLBCL but they included selected patient populations, making application of results in routine clinical practice difficult. In addition, some of the studies based on imaging-response were not randomized and are being promoted as adequate evidence to omit RT, leading to further confusion and variation in practice. On the other hand, RT is increasingly being used in salvage treatment programs for DLBCL including CAR-T cellular therapy. The evidence in this context is mostly retrospective and is heterogeneous as the field is moving fast and prospective studies have just started. Radiation oncologists, particularly community oncologists need to keep up-to-date with new data and the changing role of RT to be able to work collaboratively with medical oncologists/hematologists and also with patients, guiding them to make better informed decisions. This activity discusses recent evidence and how it can be applied in routine clinical practice with emphasis on patient selection to maximize benefit and reduce toxicity with plenty of clinical examples.

Topics:

  1. A. Introduction to Session/Presenter Introductions
    George Mikhaeel, MD, MBBS
    B. How to Interpret and Apply Recent Studies on the Role of Consolidation RT in the Primary Treatment of Early and Advanced Stage DLBCL?
    Joanna C.Yang, MD, MPH 
  2. Which Cases with Incomplete Response/Refractory/Relapsed DLBCL can be Salvaged with RT?
    Andrea K. Ng, MD, FASTRO, MPH 
  3. Which Cases Benefit from Radiotherapy with CAR-T Cellular Therapies?
    Brandon Imber, MD, MA
  4. Future Developments of CAR T-cell Therapy and Bispecifics in LBCL
    Caron Jacobson, MD
  5. Q and A
    Full Panel

This activity is available from February 20, 2024, through 11:59 p.m. Eastern time on February 19, 2026. 

This activity was originally recorded at the 2023 ASTRO Annual Meeting.

Target Audience

The activity is designed to meet the interests of medical oncologists, radiation oncologists, nurses, radiation dosimetrists, radiation therapists, residents, and hematologists. 

Learning Objectives

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

  • Determine which patients benefit from consolidation RT for the primary treatment of DLBCL and discuss the evidence with hematologists and patients.
  • Differentiate between cases with incomplete response to chemotherapy who can be successfully treated with RT and those who would be better treated with salvage systemic therapy. 
  • Assess patient and disease factors to select patients for bridging RT before CAR-T therapy and explain the selection to hematologists and patients. 
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 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: 
02/20/2024
Course expires: 
02/19/2026
Cost:
$0.00
Rating: 
0
  • George Mikhaeel, MD, MBBS, is employed by School of Cancer and Pharmaceutical Sciences, King's College London. 
  • Joanna C. Yang, MD, MPH, is employed by Washington University in St. Louis.  
  • Andrea K. Ng, MD, FASTRO, MPH, is employed by Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School. Dr. Ng receives royalties from UpToDate and Elsevier.
  • Brandon Stuart Imber, MD, MA, is employed by Memorial Sloan Kettering Cancer Center. Dr. Imber's institution receives funding from AstraZeneca, Novartis, GT Medical Technologies, and Kazia Therapeutics. He receives honoraria from GT Medical Technologies. 
  • Caron Jacobson, MD, is employed by the Dana-Farber Cancer Institute. Dr. Jacobson has served as a consultant for Kite/Gilead, Novartis, BMS/Celgene, Ipsen, Instill Bio, Abintus Bio, Miltenyi, Morphosys, Caribou Bio, Daiichi-Sankyo, ImmPACT Bio, Abbvie, ADC Therapeutics, Synthekine, and Sana. She receives research funding from Kite and Pfizer.

The person(s) above served as the developer(s) of this activity. Additionally, the Education Committee had control over the content of this activity. All relevant relationships have been mitigated.

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

ASTRO is awarded Deemed Status by the American Board of Radiology to provide SA-CME as part of Part II Maintenance of Certification. 

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 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:
$0.00
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/Grad Student/PGY: $49
Postdoctoral Fellow: $49
 

Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the course by the end of the qualification date. The qualification date for each course is listed in the course catalog on the ASTRO website under availability.

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

The course and its materials will only be available on the ASTRO website until February 19, 2026, regardless of purchase date. At the expiration of the qualification, participants will no longer have access to the course or its materials. ASTRO reserves the right to remove a course before the end of its qualification period.

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